Bradley E Gustafson, MD
Individual provider Active NPI Internal Medicine Physician · Crosby, MN
NPI 1144807405 · NPPES record last updated Oct 24, 2024
Key facts
- NPI
- 1144807405
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 75944 (MN)
- Practice address
- 320 East Main St
Crosby, MN 56441 - Phone
- (218) 546-7000
- Fax
- (218) 546-4400
- NPI assigned
- Mar 24, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- University of Texas Medical School at San Antonio, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cuyuna Regional Medical Center
Practice addresses (Care Compare)
320 E Main St
Crosby, MN 56441-1645
Phone (218) 546-7000
Hospital & facility affiliations
- Cuyuna Regional Medical Center
- North Memorial Health Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240718002304 | MN | Practitioner - Hospitalist |
6002215548 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75944 | MN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cuyuna Regional Medical Center | Current |
Accepting new patients | |
| Cuyuna Regional Medical Center | Current | Accepting new patients | |
| Cuyuna Regional Medical Center | Current |
Accepting new patients |
Locations
320 E Main St
Crosby, MN 56441
Phone (218) 546-7000
Interoperability endpoints
- bradley.gustafson@hca7.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 75944 | MN | Yes |
Addresses
Primary practice location
320 East Main St
Crosby, MN 56441
Mailing address
320 East Main St
Crosby, MN 56441
Phone (218) 546-7000
Other providers in Crosby, MN
- Monica Louise Goodwin
- Jack William Gordon
- Rebekah Lynn Gorny
- Shelby Gregg
- Mark W Gujer
- Ashley Laura Hanson
- Marcella M Hanson
- Nancy Heise
- Samantha Henrichs
- Emily A Hilgers
All providers in Crosby, MN · Internal Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.