MAXINE RAE GUSTAFSON (PA-C) – Physician Assistant, NPI 1083127203
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
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Provider Addresses for MAXINE RAE GUSTAFSON (PA-C)
France Avenue South, 44th and France, Edina, Hennepin County, Minnesota, 55431, United States
EDINA, MN 554352176
Phone: (952) 927-6501
Fax: (952) 653-1433
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 35 Open Payments records for all available years, with a total value of $1,100.
Total Amount is formed as General ($1,100) + Research ($0) + Ownership ($0) = $1,100.
Last reported payment date: 2024-11-16 • Largest payer in this snapshot: Axonics, Inc. ($189).
Total Amount
$1,100
General + Research + Ownership
Payments
35
Total payment records
General Amount
$1,100
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-16
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-01-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180105000396 | I | Physician Assistant | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 81002 | Urinalysis, manual test | 126 | 84 | $0 |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 117 | 88 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 113 | 78 | $0 |
| 87086 | Bacterial colony count, urine | 45 | 27 | $0 |
| 87088 | Bacterial urine culture | 38 | 20 | $0 |
Insurance plans in this area (ZIP 55435)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease | CO | |
| Qualified Audiologist | MN | |
| Family Practice | MN | |
| - | MN | |
| Family Practice | MN | |
| Nurse Practitioner | ND | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN |
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