REBEL K GUSTAFSON MSW, LICSW
NPI 1407061047
Social Worker - Clinical in Duluth, MN
About Rebel K Gustafson Msw, Licsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REBEL K GUSTAFSON MSW, LICSW (NPI 1407061047) is an individual clinical provider in Duluth, Minnesota, licensed in Minnesota (8719) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1995).
NPPES Registry Identity
Specialties & Licenses
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
Rebel K Gustafson Msw, Licsw 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 Rebel Gustafson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Maple Grove, MN 55369
- Reassigned Medicare billing, Minnesota enrollment
- 21 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
DULUTH, MN 55805
DULUTH, MN 55805
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 Rebel Gustafson's NPI number?
The NPI number for Rebel Gustafson is 1407061047. It was assigned to this individual provider in the NPPES registry on May 14, 2007.
Where is Rebel Gustafson located?
Rebel Gustafson practices at 407 E 3rd St, Duluth, MN 55805. The listed phone number is (218) 786-4000.
What is Rebel Gustafson's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Rebel Gustafson enrolled in Medicare?
Yes. Rebel 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 Rebel Gustafson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Rebel Gustafson reassigns Medicare benefits to Innovative Psychological Consultants, LLC (Maple Grove, 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 Rebel 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 Rebel Gustafson was last updated on September 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Rebel K Gustafson, MSW, LICSW · NPI 1407061047
Clinical provider in Duluth, Minnesota. Individual provider, active in the CMS NPPES registry since May 14, 2007.
## Identity
- **NPI:** 1407061047 (Entity type: Individual)
- **Enumerated:** May 14, 2007
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 8719 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 407 E 3RD ST, Duluth, MN 55805-1950
- **Phone:** (218) 786-4000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Innovative Psychological Consultants, LLC (NPI 1942221080, Maple Grove, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1995
## Record status
- **NPPES last updated:** September 29, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1407061047) · Data from the CMS NPPES public registry.