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

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: October 25, 2026.

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
Open in Google Maps ↗

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Susan Gustafson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Stone Arch Psychology And Health Services
Same address
Clinical
219 MAIN ST SE STE 400
Minneapolis, MN 55414
  • Reassigned Medicare billing, Minnesota enrollment
  • 12 clinicians in this Medicare group
NPI 1124398607 (612) 886-2524

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
MR. DAVID WESLEY WERNER LICSW
Social Worker (Clinical)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
DR. LISA JENNET TRUMP PH.D., LMFT
Psychologist (Family)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County
KRISTEN ELIZABETH RACHEL DOUCETTE MA, LPCC
Counselor (Mental Health)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
STEPHANIE M MICHAELS PSYD, LP
Psychologist (Counseling)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
MS. JENNIFER ANN LACROIX MA, LMFT
Marriage & Family Therapist
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
MATTHEW JOHNSON MA LPCC
Counselor (Professional)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524
RAPHAEL ANTHONY SZYKOWSKI LICSW
Social Worker (Clinical)
219 SE MAIN ST STE 400
MINNEAPOLIS, MN 55414
Hennepin County (612) 886-2524

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Susan Gustafson located?

Susan Gustafson practices at 219 SE Main St Ste 400, Minneapolis, MN 55414. The listed phone number is (612) 886-2524.

What is Susan Gustafson's specialty?

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

Is Susan Gustafson enrolled in Medicare?

Yes. Susan Gustafson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Susan Gustafson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susan Gustafson reassigns Medicare benefits to Stone Arch Psychology And Health Services (Minneapolis, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Susan Gustafson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Susan Gustafson accept?

Health plans from HealthPartners list Susan Gustafson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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.