Active NPI
Cheryl Janene Gustafson, MD
- MOHS-Micrographic Surgery Physician
- Seattle, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- MOHS-Micrographic Surgery Physician
- License
- MD60757392
- Practice address
- 3216 NE 45TH PL Ste 101
Seattle, WA 98105-4028 - Phone
- (206) 525-1168
- Fax
- (206) 525-1169
- NPI assigned
- Jun 10, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 01075298A | IN | |
| MOHS-Micrographic Surgery Physician | 207ND0101X | MD60757392 | WA | Primary |
Addresses
Primary practice location
3216 NE 45TH PL Ste 101
Seattle, WA 98105-4028
Mailing address
PO Box 24325
Seattle, WA 98124-0325
Phone (062) 327-5462
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2084320 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- University of Nevada School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3216 NE 45TH PL
Suite 203
Seattle, WA 98105-4028
Phone (206) 525-1168
Hospital & facility affiliations
- Swedish Edmonds Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 32 |
| Removal of skin lesions | 457 |
| Removal of skin cancer | 130 |
| Removal or shaving of skin growth | 39 |
| Skin biopsy | 225 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silver Falls Dermatology, LLC | Dermatology | Current | Accepting new patients |
Locations
1793 13th St SE
Salem, OR 97302
Phone 50336283851283
1515 116th Ave NE
Ste 307
Bellevue, WA 98004
Phone (425) 999-2628
21727 76th Ave W
Ste H
Edmonds, WA 98026
Phone (425) 672-1333
21701 76th Ave W
Ste 100
Edmonds, WA 98026
Phone (206) 525-1168
21701 76th Ave W
Ste 302
Edmonds, WA 98026
Phone (425) 502-5427
1301 4th Ave NW
Ste 302
Issaquah, WA 98027
Phone (206) 305-9963
1106 Douglas St
Ste F
Longview, WA 98632
Phone (360) 636-4500
1338 Commerce Ave
Ste 106
Longview, WA 98632
Phone (971) 915-8587
8435 SE 68th St
Ste 118
Mercer Island, WA 98040
Phone (206) 232-7546
3825 Martin Way E
Ste 104
Olympia, WA 98506
Phone (971) 915-8579
11011 Meridian Ave N
Ste 102
Seattle, WA 98133
Phone (206) 859-5777
3216 NE 45th Pl
Ste 203
Seattle, WA 98105
Phone (206) 525-1168
2415 NE 134th St
Ste 107
Vancouver, WA 98686
Phone (360) 576-3340
Interoperability endpoints
- cgustafson@frontierdermpartners.emadirect.md
Organizations & group practices 1
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 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Edmonds, WA
- NPI 1033107214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611878400000",
"number": "1083840565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24325",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981240325",
"telephone_number": "062-327-5462",
"fax_number": "503-362-8435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3216 NE 45TH PL STE 101",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981054028",
"telephone_number": "206-525-1168",
"fax_number": "206-525-1169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTAFSON",
"first_name": "CHERYL",
"middle_name": "JANENE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-10",
"last_updated": "2021-01-29",
"certification_date": "2021-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IN",
"license": "01075298A",
"primary": false
},
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "WA",
"license": "MD60757392",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2084320",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.