Michelle Lee Gustafson, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10595 Issued in MN

Practice address

Fairview University Hospital
2450 Riverside Avenue South
MPLS, MN 55454

Phone

(612) 273-5640

NPI assigned

May 31, 2006

Sex

Female

Sole proprietor

Yes

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.

• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606

  MN

  Medicare reassignment Care Compare group
• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265

  MN

  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175

  MN

  Medicare reassignment
• Fairview Express Care

  • Cardiovascular Disease Physician
  • Minneapolis, MN
  • NPI 1629224258
  Care Compare group
• Fairview Express Care

  • Eyewear Supplier
  • Eagan, MN
  • NPI 1750833562
  Care Compare group
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  Care Compare group
• Fairview Express Care

  • Eyewear Supplier
  • Brooklyn Park, MN
  • NPI 1841472644
  Care Compare group
• Fairview Express Care

  • Eyewear Supplier
  • Andover, MN
  • NPI 1861674665
  Care Compare group
• Fairview Express Care

  • Eyewear Supplier
  • Fridley, MN
  • NPI 1942482740
  Care Compare group
• Fairview Express Care

  • Clinic/Center
  • Hudson, WI
  • NPI 1467159210
  Care Compare group
• Fairview Express Care

  • Family Medicine Physician
  • Edina, MN
  • NPI 1538542204
  NPD
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Express Care 1,946 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 6, 2023.

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1700823952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-672-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FAIRVIEW UNIVERSITY HOSPITAL",
            "address_2": "2450 RIVERSIDE AVENUE SOUTH",
            "city": "MPLS",
            "state": "MN",
            "postal_code": "55454",
            "telephone_number": "612-273-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "10595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Eugene Erickson, DDS
• Gary S Francis, MD
• James Robert Gambucci, DDS
• Luis Miguel Garcia-Garcia
• Tracy Patricia Gierman
• Isuroon
• Talia Amo Jackson, PSYD, LP
• Debra Joann Jones, RN
• Deborah K Klein, MD
• Whitney Eliesbeth Lambert, D.C.

• All providers in MPLS, MN
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.