KIMBERLY LYNN GUSTAFSON OT
NPI 1154722346
Occupational Therapist - Hand in Edina, MN
About Kimberly Lynn Gustafson Ot NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMBERLY LYNN GUSTAFSON OT (NPI 1154722346) is an individual hand provider in Edina, Minnesota, licensed in Minnesota (104692) and active in the NPI registry since September 2014. She is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kimberly Lynn Gustafson Ot is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kimberly Gustafson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Bloomington, MN 55431
- Reassigned Medicare billing, Minnesota enrollment
- 728 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
EDINA, MN 55435
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 Kimberly Gustafson's NPI number?
The NPI number for Kimberly Gustafson is 1154722346. It was assigned to this individual provider in the NPPES registry on September 8, 2014. The provider is also known as Kimberly Lynn Mcclintick Ot.
Where is Kimberly Gustafson located?
Kimberly Gustafson practices at 4010 W 65th St, Edina, MN 55435. The listed phone number is (952) 456-7000.
What is Kimberly Gustafson's specialty?
The primary specialty registered for this NPI is Occupational Therapist, specializing in Hand, with taxonomy code 225XH1200X.
Is Kimberly Gustafson enrolled in Medicare?
Yes. Kimberly Gustafson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kimberly Gustafson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Gustafson reassigns Medicare benefits to Infinite Health Collaborative, PA (Bloomington, 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 Kimberly Gustafson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kimberly Gustafson was last updated on February 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Kimberly Lynn Gustafson, OT · NPI 1154722346
Hand provider in Edina, Minnesota. Individual provider, active in the CMS NPPES registry since September 8, 2014.
## Identity
- **NPI:** 1154722346 (Entity type: Individual)
- **Enumerated:** September 8, 2014
- **Primary specialty:** Occupational Therapist - Hand · taxonomy 225XH1200X
- **State license:** 104692 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 4010 W 65TH ST, Edina, MN 55435-1706
- **Phone:** (952) 456-7000 · **Fax:** (952) 456-7001
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Infinite Health Collaborative, PA (NPI 1164474250, Bloomington, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** February 12, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1154722346) · Data from the CMS NPPES public registry.