NPIMap

Individual provider Active NPI

Gail M Gustafson, CRNP

  • Adult Health Nurse Practitioner
  • Harrisburg, PA
National Provider Identifier
1609929736
Registry record updated Jan 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP012635 Issued in PA
Practice address
205 S Front St
4TH Floor, Bma
Harrisburg, PA 17104-1619
Phone
(717) 231-8555
Fax
(717) 231-8568
NPI assigned
Jan 20, 2007
Last updated
Jan 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP012635 PA Primary
Registered Nurse 163W00000X RN644665 PA

Addresses

Primary practice location

205 S Front St
4TH Floor, Bma
Harrisburg, PA 17104-1619

Mailing address

409 South Front St
Ste 2F
Harrisburg, PA 17104-1621
Phone (717) 231-8555

Other identifiers 1

IdentifierTypeStateIssuer
103079740MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ggustafson7661@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130614000286 PA Practitioner - Nurse Practitioner 4486820602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Cardiovascular Institute IncGroup PAC ID 6901087006, 117 clinicians

Practice addresses (Care Compare)

1703 Innovation Dr
Suite 4120
York, PA 17408-8815
Phone (717) 849-5576

205 S Front St
Harrisburg, PA 17104-1619
Phone (717) 231-8555

360 Alexander Spring Rd
Carlisle, PA 17015-9129
Phone (717) 243-6557

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.6 of 100Reported as group
Quality
70.07
Promoting interoperability
100
Improvement activities
40
Cost
71.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN644665PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Mar 13, 2013 Accepting new patients
Pinnacle Health Medical Services CurrentSince Mar 13, 2013 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Pinnacle Health Cardiovascular Institute Inc CurrentSince Jul 1, 2013 Accepting new patients
Pinnacle Health Medical Services Past Accepting new patients

Locations

360 Alexander Spring Rd
Carlisle, PA 17015
Phone (717) 243-6557

205 S Front St
#4
Harrisburg, PA 17104
Phone (717) 231-8555

205 S Front St
Fl 4
Harrisburg, PA 17104
Phone (717) 231-8555

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

1995 Technology Pkwy
Mechanicsburg, PA 17050
Phone (717) 791-2600

Organizations & group practices 5

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609545600000",
    "number": "1609929736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 SOUTH FRONT ST",
            "address_2": "STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041621",
            "telephone_number": "717-231-8555",
            "fax_number": "717-231-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S FRONT ST",
            "address_2": "4TH FLOOR, BMA",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041619",
            "telephone_number": "717-231-8555",
            "fax_number": "717-231-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "GAIL",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-20",
        "last_updated": "2021-01-02",
        "certification_date": "2021-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP012635",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN644665",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103079740",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ggustafson7661@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "205 S Front St",
            "address_2": "4th Floor, BMA",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171041619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.