Blake M Gustafson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15-02895 Issued in KS

Practice address

4000 Cambridge St
Kansas City, KS 66160-8501

Phone

(913) 588-1227

NPI assigned

Jan 24, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Kansas Health System Olathe Hospital Hospital, Olathe, KS, CCN 170049

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Kansas University Physicians Inc

  • Internal Medicine Physician
  • Kansas City, KS
  • NPI 1003858333
  Medicare reassignment Care Compare group
• University of Kansas Hospital Authority

  • Multi-Specialty Clinic/Center
  • Kansas City, KS
  • NPI 1528019502
  Medicare reassignment NPD
• Emergency Medicine Services of KS, PA

  • Emergency Medicine Physician
  • Overland Park, KS
  • NPI 1649979451
  Medicare reassignment
• Midwest Emergency Medical Services PC

  • Emergency Medicine Physician
  • North Kansas City, MO
  • NPI 1578556023
  Medicare reassignment
• Kansas University Physicians Inc

  • Cardiovascular Disease Physician
  • Kansas City, KS
  • NPI 1407637291
  NPD
• Kansas University Physicians, Inc.

  • Emergency Medicine Physician
  • Kansas City, KS
  • NPI 1467234104
  NPD
• University of Kansas Hospital Authority

  • Dentist
  • Westwood, KS
  • NPI 1295845758
  NPD

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

• Olathe Medical Center Inc

  • General Acute Care Hospital
  • Olathe, KS
  • NPI 1144266115
  Care Compare affiliation

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1326800574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 MARRIOTT DR # A",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372145048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CAMBRIDGE ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608501",
            "telephone_number": "913-588-1227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "616 Marriott Dr",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372145048",
            "country_code": "US",
            "telephone_number": "629-802-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20333 W 151st St",
            "address_purpose": "LOCATION",
            "city": "Olathe",
            "state": "KS",
            "postal_code": "660615350",
            "country_code": "US",
            "telephone_number": "913-588-1227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "BLAKE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-24",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02895",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2024004731",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aditi Gupta, M.D.
• Chakshu Gupta, MD
• Kamal Gupta, MD
• Mallika Gupta, MD
• Madeleine Gurney, MD
• Kelsey Gustafson, MD
• Erica Gutierrez, LCSW, LSCSW
• Hemalatha Gutta, MBBS
• Kaylee Guyett
• Grace Gyllenborg

• Physician Assistant in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.

Verify at the official NPI Registry.