DR. CHERYL JANENE GUSTAFSON (MD) – MOHS-Micrographic Surgery Physician, NPI 1083840565
MOHS-Micrographic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
393 DERMATOLOGY in WA
Provider Addresses for DR. CHERYL JANENE GUSTAFSON (MD)
3216 NE 45TH PL STE 101
SEATTLE, WA 981054028
Phone: (206) 525-1168
Fax: (206) 525-1169
Type: Location
13400, North Meridian Street, Carmel, Hamilton County, Indiana, 46032, United States
SUITE 290
CARMEL, IN 460327102
Phone: (317) 660-4900
Fax: (317) 660-4901
Type: Mailing
PO BOX 24325
SEATTLE, WA 981240325
Phone: (062) 327-5462
Fax: (503) 362-8435
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 31 Open Payments records for all available years, with a total value of $644.
Total Amount is formed as General ($644) + Research ($0) + Ownership ($0) = $644.
Last reported payment date: 2024-10-31 • Largest payer in this snapshot: ABBVIE INC. ($236).
Total Amount
$644
General + Research + Ownership
Payments
31
Total payment records
General Amount
$644
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $236 |
| Incyte Corporation | $101 |
| Novartis Pharmaceuticals Corporation | $59 |
| Lilly USA, LLC | $52 |
| GENZYME CORPORATION | $49 |
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: 2017-07-20
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 |
|---|---|---|---|---|
| I20170720002975 | I | Dermatology | WA | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 600 | 421 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 489 | 101 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 297 | 228 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 220 | 186 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 192 | 25 | $0 |
Insurance plans in this area (ZIP 98105)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | IN | 17003 | Destruction of 2-14 skin growths | 55 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | WA | |
| D E R M A T O L O G Y | OR | |
| Physician Assistant | WA | |
| D E R M A T O L O G Y | WA | |
| D E R M A T O L O G Y | WA | |
| Nurse Practitioner | WA | |
| - | WA | |
| - | OR | |
| - | OR | |
| Physician Assistant | WA |
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