Individual provider Active NPI

Gustaaf Cornelis Van Soestbergen, CRNA MSN MPA

  • Certified Registered Nurse Anesthetist
  • Cheektowaga, NY
National Provider Identifier
1033211131
Registry record updated May 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
173 Issued in NC
Practice address
2568 Walden Ave Ste 103-105
Cheektowaga, NY 14225-4760
Phone
(716) 632-1088
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 397403 NY
Certified Registered Nurse Anesthetist 367500000X 086274-23 NH
Certified Registered Nurse Anesthetist 367500000X 173 NC Primary
Certified Registered Nurse Anesthetist 367500000X 0105995 NC

Addresses

Primary practice location

2568 Walden Ave Ste 103-105
Cheektowaga, NY 14225-4760

Mailing address

2568 Walden Ave Ste 103-105
Cheektowaga, NY 14225-4760
Phone (716) 632-1088

Other identifiers 2

IdentifierTypeStateIssuer
NAN754MedicaidSC
8052174MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NH, NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040616000312 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375527443 Reassigns benefits to 3 organizations
I20211116001062 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375527443 Reassigns benefits to 1 organization
I20241108000443 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375527443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maple Gate Anesthesiologists, P.C.Group PAC ID 8022913839, 113 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 632-1088

1540 Maple Rd
Williamsville, NY 14221-3647
Phone (716) 632-1088

875 Ellicott St
Gates Vascular Institute
Buffalo, NY 14203-1070
Phone (716) 632-1088

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
173NCMDAddiction (Substance Use Disorder) Counselor
0105995NCMDCertified Registered Nurse Anesthetist
086274-23NHMDCertified Registered Nurse Anesthetist
397403NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Gate Anesthesiologists, P.C. CurrentSince Nov 1, 2024 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Oct 25, 2021 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 29, 2024 Accepting new patients
East Carolina Anesthesia Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2019 Accepting new patients
CHS Anesthesia Services Group Inc CurrentSince Nov 28, 2017 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC CurrentSince Jul 29, 2024 Accepting new patients
Mercy Hospital, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

2825 Randolph Rd
Charlotte, NC 28211
Phone (704) 377-1647

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

105 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 686-2840

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

2568 Walden Ave
Ste 103105
Cheektowaga, NY 14225
Phone (716) 632-7842

2568 Walden Ave
Ste 103
Cheektowaga, NY 14225

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

30 S Cayuga Rd
Williamsville, NY 14221

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778284800000",
    "number": "1033211131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2568 WALDEN AVE STE 103-105",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254760",
            "telephone_number": "716-632-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2568 WALDEN AVE STE 103-105",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254760",
            "telephone_number": "716-632-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SOESTBERGEN",
        "first_name": "GUSTAAF",
        "middle_name": "CORNELIS",
        "name_prefix": "Mr.",
        "credential": "CRNA MSN MPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2026-05-09",
        "certification_date": "2026-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "397403",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "086274-23",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "173",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "0105995",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NAN754",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052174",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.