CAMILLE MICHELLE GUSTAFSON – Occupational Therapist, NPI 1689989550

CAMILLE MICHELLE GUSTAFSON is a healthcare provider. based in Mantorville, Minnesota. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 002077 (IA). The NPI Number for CAMILLE MICHELLE GUSTAFSON is 1689989550

Main info

Female
Sole Proprietor
16 Years Of Experience
Accepts Medicare Assignment
Name
CAMILLE MICHELLE GUSTAFSON
NPI
1689989550
Phone
(507) 384-2916
Address
821 1/2 WEST ST
Enumeration Date
16 August 2010
Last Update Date
16 August 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3193132056
Graduation Year
2010 (16 years ago)
PAC ID
2264827724
Group Practice PAC ID
7315073954
Professional Enrollment ID
I20220318001535
Address ID
IA524027203CE6325XNEXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

252 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in IA

Provider Addresses for CAMILLE MICHELLE GUSTAFSON

  • 821 1/2 WEST ST

    MANTORVILLE, MN 559558056

    Phone: (507) 384-2916

    Type: Mailing

  • 1552 MALL DR

    IOWA CITY, IA 522403110

    Phone: (319) 351-5437

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2022-03-18

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
I20220318001535IOccupational Therapist In Private PracticeIATBD

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 55955)

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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: 7315073954View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIA
Physical Therapist In Private PracticeKS
Occupational Therapist In Private PracticeKS
Qualified Speech Language PathologistKS
Physical Therapist In Private PracticeAL
Occupational Therapist In Private PracticeMO
Occupational Therapist In Private PracticeNJ
Physical Therapist In Private PracticeKS
-KS
Qualified Speech Language PathologistPA

Reviews

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Frequently asked questions

What is CAMILLE MICHELLE GUSTAFSON's NPI number?
CAMILLE MICHELLE GUSTAFSON's NPI is 1689989550 — the number used across U.S. healthcare to identify this provider.
Is there an active status for CAMILLE MICHELLE GUSTAFSON?
For scheduling context, CAMILLE MICHELLE GUSTAFSON is shown as active in the registry.
What clinical focus is listed for CAMILLE MICHELLE GUSTAFSON?
At a glance, CAMILLE MICHELLE GUSTAFSON is tied to Occupational Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with CAMILLE MICHELLE GUSTAFSON?
Directory geography for CAMILLE MICHELLE GUSTAFSON centers on Mantorville, Minnesota.
When was this NPI issued?
Enumeration for CAMILLE MICHELLE GUSTAFSON is noted as August 16, 2010 where the registry provides it.

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