CRAIG ROBERT GUSTAFSON – Physical Therapist, NPI 1629685573

CRAIG ROBERT GUSTAFSON is a healthcare provider. based in Deer park, Washington. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. The NPI Number for CRAIG ROBERT GUSTAFSON is 1629685573

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
CRAIG ROBERT GUSTAFSON
NPI
1629685573
Phone
(509) 276-8811
Address
707 S PARK ST
Enumeration Date
24 September 2020
Last Update Date
22 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5092768811
Graduation Year
2020 (6 years ago)
PAC ID
5294145413
Group Practice PAC ID
6103716840
Professional Enrollment ID
I20240918004580
Address ID
WA990067025DE707XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:5State licenses:0Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for CRAIG ROBERT GUSTAFSON

  • 707 S PARK ST

    DEER PARK, WA 990067025

    Phone: (509) 276-8811

    Type: Location

  • 16400 FRENCHTOWN FRONTAGE RD

    FRENCHTOWN, MT 598349301

    Phone:

    Type: Mailing

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: 2024-09-18

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
I20240918004580IPhysical Therapist In Private PracticeWATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities1,58851$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes30023$0
97016Application of blood vessel compression device11411$0
97140Therapy procedure using manual technique, each 15 minutes9919$0
97161Evaluation for physical therapy, typically 20 minutes3431$0
View full utilization report →

Insurance plans in this area (ZIP 99006)

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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: 6103716840View full group profile
NameSpecialtyState
-WA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA

Reviews

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Frequently asked questions

Is CRAIG ROBERT GUSTAFSON listed with a National Provider Identifier?
Yes — CRAIG ROBERT GUSTAFSON has NPI 1629685573 on file in the registry.
Is there an active status for CRAIG ROBERT GUSTAFSON?
For scheduling context, CRAIG ROBERT GUSTAFSON is shown as active in the registry.
What area of care is associated with CRAIG ROBERT GUSTAFSON?
CRAIG ROBERT GUSTAFSON's record emphasizes Physical Therapist. Clinical services aligned with this taxonomy classification.
Is CRAIG ROBERT GUSTAFSON associated with Deer Park?
Public fields place CRAIG ROBERT GUSTAFSON around Deer Park, Washington. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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