Dr Mikayla Nicole Gustafson, AUD - Medicare Audiologist in Fergus Falls, MN

Dr Mikayla Nicole Gustafson, AUD is a medicare enrolled "Audiologist" provider in Fergus Falls, Minnesota. Her current practice location is 119 N Union Ave Unit 1, Fergus Falls, Minnesota. You can reach out to her office (for appointments etc.) via phone at (701) 330-7758.

Dr Mikayla Nicole Gustafson is licensed to practice in Minnesota (license number 10480) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1871207373.

Contact Information

Dr Mikayla Nicole Gustafson, AUD
119 N Union Ave Unit 1,
Fergus Falls, MN 56537-2126
(701) 330-7758
Not Available



Healthcare Provider's Profile

Full NameDr Mikayla Nicole Gustafson
GenderFemale
SpecialityAudiologist
Location119 N Union Ave Unit 1, Fergus Falls, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1871207373
  • Provider Enumeration Date: 01/09/2023
  • Last Update Date: 11/20/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 6103284310
  • Enrollment ID: I20230621000592

Medical Identifiers

Medical identifiers for Dr Mikayla Nicole Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1871207373NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
231H00000XAudiologist 10480 (Minnesota)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Mikayla Nicole Gustafson allows following entities to bill medicare on her behalf.
Provider NameLake Region Healthcare Corporation
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1093713372
PECOS PAC ID: 3971565334
Enrollment ID: O20060109000246

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mikayla Nicole Gustafson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Mikayla Nicole Gustafson, AUD
8090 Eden Rd Apt 435,
Eden Prairie, MN 55344-7693

Ph: (701) 330-7758
Dr Mikayla Nicole Gustafson, AUD
119 N Union Ave Unit 1,
Fergus Falls, MN 56537-2126

Ph: (701) 330-7758

News Archive

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Audiologist in Fergus Falls, MN

Paul Sanderson, MS
Audiologist
Medicare: Medicare Enrolled
Practice Location: 712 South Cascade Street, Fergus Falls, MN 56537
Phone: 218-736-8000    Fax: 218-736-8757
Dr. Courtney Fochs, AUD
Audiologist
Medicare: Accepting Medicare Assignments
Practice Location: 712 S Cascade St Fergus Falls, Fergus Falls, MN 56537
Phone: 218-736-8000    

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