Ellen Gustafson
NPI 1417707563 · Physician Assistant · Minneapolis, MN
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ellen Gustafson is a Physician Assistant provider in Minneapolis, MN (NPI 1417707563).
Provider details
- NPI number
- 1417707563
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 14847 (MN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-03-22
- Last updated
- 2024-06-04
- Certified
- 2024-06-04
Frequently asked questions
- What is Ellen Gustafson's NPI number?
- Ellen Gustafson's National Provider Identifier (NPI) is 1417707563, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ellen Gustafson's specialty?
- Ellen Gustafson is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Ellen Gustafson located?
- Ellen Gustafson's practice location on file with NPPES is 701 Park Ave, Minneapolis, MN 55415-1623.
- What is Ellen Gustafson's phone number?
- The practice phone number listed in the NPPES registry for Ellen Gustafson is (612) 873-6963.
- Does Ellen Gustafson accept Medicare?
- Ellen Gustafson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Ellen Gustafson's NPI active?
- Yes — Ellen Gustafson's NPI (1417707563) is active in the NPPES registry as of the last update on 2024-06-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.