NATALIE JANE GUSTAFSON (NP) – Family Nurse Practitioner, NPI 1144578568

NATALIE JANE GUSTAFSON (NP) is a healthcare provider. based in Grand rapids, Minnesota. specializing in Family Nurse Practitioner. They hold the professional credentials NP. They hold a License No. R178810-1 (MN). The NPI Number for NATALIE JANE GUSTAFSON (NP) is 1144578568

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
NATALIE JANE GUSTAFSON (NP)
NPI
1144578568
Phone
(218) 999-7000
Address
1542 GOLF COURSE RD STE 204
Enumeration Date
15 August 2012
Last Update Date
26 September 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2187864000
Graduation Year
2012 (14 years ago)
PAC ID
4688824758
Group Practice PAC ID
2567374283
Professional Enrollment ID
I20121025000706
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:13State licenses:2Digital endpointsOther names

Provider Addresses for NATALIE JANE GUSTAFSON (NP)

  • 1542 GOLF COURSE RD STE 204

    GRAND RAPIDS, MN 557443555

    Phone: (218) 999-7000

    Type: Location

  • 20 5TH ST SE

    COOK, MN 557239702

    Phone: (218) 666-5941

    Fax: (218) 666-5099

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $268.

Total Amount is formed as General ($268) + Research ($0) + Ownership ($0) = $268.

Last reported payment date: 2024-03-04 • Largest payer in this snapshot: ABBVIE INC. ($228).

Total Amount

$268

General + Research + Ownership

Payments

4

Total payment records

General Amount

$268

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-04

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$228
Allergan, Inc.$40
View all Open Payments →|Open Payments Risk Radar →

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: 2012-10-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20121025000706INurse PractitionerMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55744)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2567374283View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMT
-ND
Physician AssistantMN
Nurse PractitionerSD
-MN
Qualified AudiologistMN
-MN
-MN
P A T H O L O G YWV
Family PracticeMN

Reviews

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Frequently asked questions

Does NATALIE JANE GUSTAFSON (NP) have a public NPI I can cite?
Public records show NATALIE JANE GUSTAFSON (NP) under NPI 1144578568.
Does the public listing show NATALIE JANE GUSTAFSON (NP) as active?
NATALIE JANE GUSTAFSON (NP)'s NPI record reflects an active status in NPPES.
How should patients interpret NATALIE JANE GUSTAFSON (NP)'s specialty?
The extract shows Family Nurse Practitioner for NATALIE JANE GUSTAFSON (NP). Clinical services aligned with this taxonomy classification.
Which community is linked to NATALIE JANE GUSTAFSON (NP)?
NATALIE JANE GUSTAFSON (NP) shows a connection to Grand Rapids, Minnesota in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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