Chase William Gulstrom, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

185188 Issued in AK

Practice address

1000 Greg Kruschek Avenue
Nome, AK 99762

Phone

(190) 744-3331

NPI assigned

Mar 30, 2018

Last updated

Sep 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Norton Sound Health CorporationGroup PAC ID 7517858137, shared by 4 NPIs, 13 clinicians

City of ValdezGroup PAC ID 3577514694, shared by 4 NPIs, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Norton Sound Regional Hospital Hospital, Nome, AK, CCN 021308
• Providence Valdez Medical Center Hospital, Valdez, AK, CCN 021301

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cgulstrom1072107@ak.providencedirect.org
• Direct secure messaging: cwgulstrom@direct.nshcorp.org

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

• City of Valdez

  dba Providence Valdez Medical Center

  • Critical Access Hospital Clinic/Center
  • Valdez, AK
  • NPI 1427424282

  Single Specialty

  Medicare reassignment NPD
• City of Valdez

  dba Providence Valdez Medical Center

  • Critical Access Hospital
  • Valdez, AK
  • NPI 1750485488

  Family Medicine

  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1154358232

  Single Specialty

  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1225101041
  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Nome, AK
  • NPI 1427187046
  NPD

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

• City of Valdez

  dba Providence Valdez Medical Center

  • Critical Access Hospital
  • Valdez, AK
  • NPI 1750485488
  Care Compare affiliation
• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1225101041
  Care Compare affiliation

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1386149391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CITY OF NOME DRIVE, BOX 1242",
            "city": "NOME",
            "state": "AK",
            "postal_code": "99762",
            "telephone_number": "808-228-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GREG KRUSCHEK AVENUE",
            "city": "NOME",
            "state": "AK",
            "postal_code": "99762",
            "telephone_number": "190-744-3331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3430 E 4th St Unit 3041",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917645066",
            "country_code": "US",
            "telephone_number": "808-228-0886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GULSTROM",
        "first_name": "CHASE",
        "middle_name": "WILLIAM",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-30",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "146077",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "185188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Bernardo Gomez Salgado, BA
• Catherine Jean Gonzales
• Seth Green
• Katie Mae Greenway
• Daniel Grimmer
• Kirsten Hagen, MA
• Kathryn Lois Hamilton, LMSW
• Hope Han, PT
• Abby Jo Hart, PHARMD
• David Matthew Head, MD

• Family Medicine Physician in Nome, AK
• Providers in Nome, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.