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Deactivated NPI 1164930285 Deactivated / Inactive NPI Male Practitioner

Jason Gustave

Specialist/Technologist - Athletic Trainer • Wayne, NJ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jason Gustave has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 11, 2018
NPI Deactivation Date April 09, 2018
Total Practice Duration ~1 Years of Practice (2018 – 2018)

Professional Overview & Biography Verified Profile Summary

Jason Gustave was a registered Specialist/Technologist - Athletic Trainer practicing in Wayne, NJ. Throughout an active medical career spanning 1 years, Jason Gustave provided care at the practice location at 300 POMPTON RD until profile deactivation on 2018-04-09.

Practice Location & Contact Primary Location

Practice Address

300 Pompton Rd

Wayne, NJ 074702103

Telephone 2017862277

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist/Technologist - Athletic Trainer in Wayne, NJ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 2.5 Yrs
Regional Practice Density
25 Specialists

Practicing in Wayne, NJ (1155 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-02-25
Specialist/Technologist - Athletic Trainer Primary Specialty

NUCC Taxonomy Code: 2255A2300X

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

39 Associated Practitioners
Bailey Wyrostek , ATC

Specialist/Technologist - Athletic Trainer

NPI 1073127809

Certified Athletic Trainer

Carlos Moreira

Student in an Organized Health Care Education/Training Program

NPI 1154911584
Fazia Weaver , NP

Nurse Practitioner - Adult Health

NPI 1174828800

Nurse Practitioner

Raquel Prada - Galvez

Specialist/Technologist - Athletic Trainer

NPI 1184250615
Samantha Corallo

Student in an Organized Health Care Education/Training Program

NPI 1184314999
Isaiah Forester-Koomson

Student in an Organized Health Care Education/Training Program

NPI 1184572505

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
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Updated Practice Location December 16, 2021

Registered at 300 POMPTON RD, WAYNE, NJ 074702103 (Tel: 2017862277)

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Updated Business Mailing Address December 16, 2021

Registered at 310 N BROAD ST, ELIZABETH, NJ 072076900

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Updated Practice Location February 25, 2021

Registered at 461 CATHERINE ST APT 109A, ELIZABETH, NJ 072013411 (Tel: 9085874411)

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Updated Business Mailing Address February 25, 2021

Registered at 461 CATHERINE ST APT 109A, ELIZABETH, NJ 072013411

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Provider Name / Credentials Updated February 25, 2021

Recorded as JASON GUSTAVE

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 25, 2021

Specialist/Technologist

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NPI Profile Deactivated April 09, 2018

Record deactivated on April 09, 2018

NPI Profile Active January 11, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location January 11, 2018

Registered at 300 POMPTON RD, WAYNE, NJ 074702103 (Tel: 9085874411)

📍
Updated Business Mailing Address January 11, 2018

Registered at 461 CATHERINE ST APT 109A, ELIZABETH, NJ 072013411

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Provider Name / Credentials Updated January 11, 2018

Recorded as JASON GUSTAVE

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 11, 2018

Student in an Organized Health Care Education/Training Program

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 11, 2018

Specialist/Technologist

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Initial NPI Registration & Enumeration January 11, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164930285
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 11, 2018
Last Update: December 16, 2021
Deactivation Date: April 09, 2018
Sole Proprietor: No

Mailing Address

310 N Broad St

Elizabeth, NJ 072076900

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.