SUSAN GUSTAFSON LP
NPI 1073686655
Psychologist - Clinical in Minneapolis, MN

Q: What is Susan Gustafson's NPI number?

The NPI number for Susan Gustafson is 1073686655. It was assigned to this individual provider in the NPPES registry on November 15, 2006.

Q: What is Susan Gustafson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Susan Gustafson was last updated on August 4, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 15, 2006PECOS Enrolled

219 SE MAIN ST STE 400, MINNEAPOLIS, MN 55414(612) 886-2524(612) 886-2538 Get Directions Write a Review

NPPES record last updated: August 4, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Susan Gustafson Lp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSAN GUSTAFSON LP (NPI 1073686655) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (LP3594) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2001).

NPPES Registry Identity

NPI1073686655

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameSUSAN GUSTAFSONCredential: LP

Location Address219 SE MAIN ST STE 400Minneapolis, MN 55414-2151

Mailing Address219 Se Main St Ste 400Minneapolis, MN 55414-2151 · (612) 886-2524 · Fax (612) 886-2538

Phone(612) 886-2524

Fax(612) 886-2538

Sole ProprietorNo

Medical School CMSOtherGraduated 2001

Enumeration DateNovember 15, 2006

Last NPPES UpdateAugust 4, 2017

✔ NPI 1073686655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MN · LP3594

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

219 SE MAIN ST STE 400, Minneapolis, MN 55414

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Other Identifiers 5

Other6153482MN · Medica Choice

Medicare ID-Type Unspecified680002104MN

Other54P16GUMN · Bcbs

Medicaid025523800FM

OtherHP49453MN · Healthpartners

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susan Gustafson Lp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8123084993

PECOS Enrollment IDI20041203000117

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55414 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$168.28 typical visit price

range $56.00 – $168.28

Typical copayment $42.07 (range $14.00 – $42.07)

Most-billed visit code 99205

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMUEL JOHNSON

Social Worker (Clinical)