Individual Healthcare Provider
Gregory Robert Gustavson, APRN
Provider's NPPES record last updated: August 18, 2026
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1770418030
- Primary Specialty
- Nurse Practitioner — Acute Care
- Practice Location
- Willimantic, Connecticut
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 10:58 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Nurse Practitioner
Acute Care
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363LA2100X Radiology
Vascular & Interventional Radiology
Allopathic & Osteopathic Physicians
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
Taxonomy code 2085R0204XNurse Practitioner
Gerontology
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363LG0600X
Provider-Reported License Information
- Nurse Practitioner (Connecticut)
- 92342
- Radiology (Connecticut)
- 12.017664
- Nurse Practitioner (Connecticut)
- 92342
Practice Locations
Practice Location
112 Mansfield Ave
Willimantic, Connecticut 06226-2040
Phone: (860) 456-9116
Additional Practice Location
326 Washington St
Norwich, Connecticut 06360-2740
Phone: (860) 889-8331
Additional Practice Location
435 Lewis Ave
Meriden, Connecticut 06451-2101
Phone: (203) 694-8928
Additional Practice Location
100 Grand St
New Britain, Connecticut 06052-2016
Phone: (860) 276-5000
Record Information
- Enumeration Date
- June 16, 2026
- Provider's NPPES Record Last Updated
- August 18, 2026
- Certification Date
- August 18, 2026
- NPISignal NPPES Dataset
- August 2026
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