Michelle R Gustafson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP8221 Issued in AZ

Practice address

1135 W University Dr Ste 425
Rochester, MI 48307-1897

Phone

(248) 650-5864

Fax

(248) 650-5865

NPI assigned

Oct 12, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Specialists in Rehabilitation Medicine PC

  • Physical Medicine & Rehabilitation Physician
  • Rochester, MI
  • NPI 1336114537
  Medicare reassignment NPD

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1497126874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 W UNIVERSITY DR STE 425",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071897",
            "telephone_number": "248-650-5864",
            "fax_number": "248-650-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 W UNIVERSITY DR STE 425",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071897",
            "telephone_number": "248-650-5864",
            "fax_number": "248-650-5865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 E McKellips Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852032525",
            "country_code": "US",
            "telephone_number": "480-223-1333",
            "fax_number": "602-382-3036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3210 E Union Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850503223",
            "country_code": "US",
            "telephone_number": "602-788-4793 x8221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Siemers Guadalupe, LMSW
• Kelly Marie Gumbrecht, M.D.
• Aditi Gupta
• Jessica Gupta, LMSW
• Krishna Kumari Gupta, MD
• Maria Jose Gutierrez Briones, MD
• H.K. Grewal MD PC
• Robert W Haag, DDS
• Beth Adriana Habbel
• Jeffrey S. Haddad, DDS

• Family Nurse Practitioner in Rochester, MI
• Providers in Rochester, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.