KATELYN GUSTAFSON PA-C
NPI 1215636121
Physician Assistant in Saint Louis, MO

Q: What is Katelyn Gustafson's NPI number?

The NPI number for Katelyn Gustafson is 1215636121. It was assigned to this individual provider in the NPPES registry on February 28, 2023.

Q: What is Katelyn Gustafson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Katelyn Gustafson was last updated on November 3, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 28, 2023PECOS EnrolledAccepts Medicare Assignment

621 S NEW BALLAS RD STE 560A, SAINT LOUIS, MO 63141(314) 251-6440(314) 251-4456 Get Directions Write a Review

NPPES record last updated: November 3, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 3, 2025, May 23, 2023, Mar 20, 2023 and 1 more (4 updates tracked since 2023).

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About Katelyn Gustafson Pa-c NPPES

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

KATELYN GUSTAFSON PA-C (NPI 1215636121) is an individual physician assistant in Saint Louis, Missouri, licensed in Missouri (2025044201) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS, is affiliated with Mercy Hospital St Louis, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1215636121

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKATELYN GUSTAFSONCredential: PA-C

Location Address621 S NEW BALLAS RD STE 560ASaint Louis, MO 63141-8261

Mailing Address621 S New Ballas Rd Ste 560aSaint Louis, MO 63141-8261 · (314) 251-6440 · Fax (314) 251-4456

Phone(314) 251-6440

Fax(314) 251-4456

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateFebruary 28, 2023

Last NPPES UpdateNovember 3, 20254 updates tracked since enumeration

NPPES CertifiedNovember 3, 2025

✔ NPI 1215636121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MO · 2025044201

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA.0007815 (CO)

621 S NEW BALLAS RD STE 560A, Saint Louis, MO 63141

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Katelyn Gustafson Pa-c 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.

PECOS PAC ID1658746789

PECOS Enrollment IDI20230403002615, I20251107003499

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.

Areas of Expertise CMS Part B claims 15

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

1,648 services141 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

316 services256 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

161 services119 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

142 services128 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

134 services102 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

114 services77 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

105 services84 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

100 services86 patients

Hyaluronan or derivative, gel-one, for intra-articular injection, per dose J7326

Hyaluronan or Gel-One is a substance injected directly into your joint space. It's aimed to supplement your body's natural joint fluid, helping to lubricate and cushion the joint, reducing pain and improving mobility. It's often used for arthritis relief.

46 services34 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

26 services26 patients

X-ray of hip, minimum of 4 views 73503

An X-ray of the hip with a minimum of 4 views is a non-invasive procedure that uses a small amount of radiation to produce images of the hip joint from different angles. This helps to diagnose conditions such as fractures, arthritis, or other abnormalities. It's a quick, painless process.

24 services18 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

19 services17 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

19 services19 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

15 services15 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

14 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Hospital St Louis

Acute Care Hospitals · Saint Louis, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260020

Location615 New Ballas RoadSaint Louis, MO 63141 · St. Louis County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63141 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

$86.32 typical visit price

range $55.65 – $169.38

Typical copayment $21.58 (range $13.91 – $42.34)

Most-billed visit code 99203

Established Patient

$69.50 typical visit price

range $17.76 – $137.92

Typical copayment $17.37 (range $4.44 – $34.48)

Most-billed visit code 99213

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

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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.

PAIGE NICOLE PONTICELLO MSN, FNP-C

Nurse Practitioner (Family)