Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1215917307 Individual Practitioner Male Practitioner

Dr. Gustaf Isaac Gibson , OD

Optometrist • Logan, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Gustaf Gibson, OD is a certified Optometrist practicing in Logan, UT. With approximately 22 years of clinical experience since graduating from Pacific University - College Of Optometry in 2004, Dr. Gibson delivers high-quality medical care to the local community at 145 W CACHE VALLEY BLVD.

Dr. Gibson accepts Medicare assignment.

Frequently performed procedures and clinical services include new patient complete exam of visual system, established patient complete exam of visual system. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

145 W Cache Valley Blvd

Logan, UT 843418473

Telephone 4357879273
Fax 4357879275
Associated Practice Facility / Clinic
🏢 Sams West Inc Facility NPI 1255358453

Medicare Profile & Education

Medical School

Pacific University - College Of Optometry

Graduation Year

2004

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Logan, UT

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
22 Yrs +2.6 yrs vs City Avg
City Avg: 19.4 Yrs
State Avg: 19.7 Yrs
Regional Practice Density
14 Specialists

Practicing in Logan, UT (484 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
21.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Gibson (22 Years) 22 Yrs
Logan Specialty Average (19.4 Years) 19.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92004 New patient complete exam of visual system
25 25 $180.00 $139.76
92014 Established patient complete exam of visual system
25 25 $150.00 $118.05

Medical Specialties & State Licenses

CMS Verified: 2023-06-15
Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License UT 5823517-9934

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Optometrist

NUCC Taxonomy Code: 152W00000X

State License OR 2994T

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

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

1 Associated Practitioners
Jesse Li

Pharmacist

NPI 1114401130

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location June 15, 2023

Registered at 145 W CACHE VALLEY BLVD, LOGAN, UT 843418473 (Tel: 4357879273)

📍
Updated Business Mailing Address June 15, 2023

Registered at 435 W 1140 N, LOGAN, UT 843416994

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 15, 2023

Optometrist (License #2994T in OR)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 34520 BOB WILSON DR, SUITE 203, SAN DIEGO, CA 921342098 (Tel: 6195325840)

📍
Updated Business Mailing Address July 08, 2007

Registered at 11574 WINDCREST LN, #1423, SAN DIEGO, CA 921286403

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as GUSTAF GIBSON, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Optometrist (License #5823517-9934 in UT)

🟢
Initial NPI Registration & Enumeration January 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Gustaf Gibson. Be the first to share your experience!

Sign in to leave a review for Dr. Gustaf Gibson

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1215917307
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 17, 2006
Last Update: June 15, 2023
Sole Proprietor: Yes

Mailing Address

435 W 1140 N

Logan, UT 843416994

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.