Individual provider Active NPI

Belinda J Gustafson, MD

  • Psychiatry Physician
  • Seattle, WA
National Provider Identifier
1730309147
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD00031667 Issued in WA
Practice address
11000 Lake City Way NE
Suite 200
Seattle, WA 98125-6748
Phone
(206) 461-3614
Fax
(206) 634-0094
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD00031667 WA Primary

Addresses

Primary practice location

11000 Lake City Way NE
Suite 200
Seattle, WA 98125-6748

Mailing address

11000 Lake City Way NE
Suite 200
Seattle, WA 98125-6748
Phone (206) 461-3614

Other identifiers 1

IdentifierTypeStateIssuer
1097450MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20080807000545 WA Practitioner - Psychiatry 9133293236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Washington School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SoundGroup PAC ID 1759282197, 50 clinicians

Practice addresses (Care Compare)

11000 Lake City Way NE
Seattle, WA 98125-6748
Phone (206) 461-3614

Hospital & facility affiliations

  • University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00031667WAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound CurrentSince Sep 8, 2020 Accepting new patients
Community Psychiatric Clinic Inc Past Accepting new patients
Sound PastSince Oct 20, 2019 Accepting new patients
Community Psychiatric Clinic Inc PastSince Jul 24, 2022 Accepting new patients

Locations

11000 Lake City Way NE
Seattle, WA 98125
Phone (206) 461-3614

1600 E Olive St
Seattle, WA 98122
Phone (206) 302-2800

11000 Lake City Way NE
Ste 200
Seattle, WA 98125
Phone (206) 461-3614

2329 4th Ave
Seattle, WA 98121
Phone (206) 461-3649

6400 Southcenter Blvd
Tukwila, WA 98188
Phone (206) 444-3600

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1730309147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 LAKE CITY WAY NE",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256748",
            "telephone_number": "206-461-3614",
            "fax_number": "206-634-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 LAKE CITY WAY NE",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256748",
            "telephone_number": "206-461-3614",
            "fax_number": "206-634-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "BELINDA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00031667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1097450",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.