Alicia Gustafson, DO - Medicare Family Practice in Bloomington, MN

Alicia Gustafson, DO is a medicare enrolled "Internal Medicine - Sports Medicine" physician in Bloomington, Minnesota. She went to Edward Via Col Of Osteo Medicine-virginia Campus and graduated in 2012 and has 12 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Texas Health Physicians Group and her current practice location is 8100 Northland Dr, Bloomington, Minnesota. You can reach out to her office (for appointments etc.) via phone at (952) 831-8742.

Alicia Gustafson is licensed to practice in Minnesota (license number 75542) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1417210790.

Contact Information

Alicia Gustafson, DO
8100 Northland Dr,
Bloomington, MN 55431-4800
(952) 831-8742
Not Available



Physician's Profile

Full NameAlicia Gustafson
GenderFemale
SpecialityFamily Practice
Experience12 Years
Location8100 Northland Dr, Bloomington, Minnesota
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Alicia Gustafson attended and graduated from Edward Via Col Of Osteo Medicine-virginia Campus in 2012
  NPI Data:
  • NPI Number: 1417210790
  • Provider Enumeration Date: 06/21/2012
  • Last Update Date: 05/10/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 1951526730
  • Enrollment ID: I20210104002157

Medical Identifiers

Medical identifiers for Alicia Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417210790NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine S9140 (Texas)Secondary
207QS0010XFamily Medicine - Sports Medicine S9140 (Texas)Secondary
207RS0010XInternal Medicine - Sports Medicine 75542 (Minnesota)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Texas Health Harris Methodist Hospital AllianceFort worth, TXHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Texas Health Physicians Group43855359541182

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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. Alicia Gustafson allows following entities to bill medicare on her behalf.
Entity NameTexas Health Physicians Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174573596
PECOS PAC ID: 4385535954
Enrollment ID: O20040323000759

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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. Alicia 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
Alicia Gustafson, DO
8170 33rd Ave S # Ms 21110q,
Bloomington, MN 55425-4516

Ph: () -
Alicia Gustafson, DO
8100 Northland Dr,
Bloomington, MN 55431-4800

Ph: (952) 831-8742

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Internal Medicine Doctors in Bloomington, MN

Constance Crane, MD
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 7920 Old Cedar Ave S, Bloomington, MN 55425
Phone: 952-851-1000    
Jerome C Siy, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 8170 33rd Ave S, Mc21110q, Bloomington, MN 55425
Phone: 651-254-9594    Fax: 651-254-3662
Christofer A. Smith, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 600 W 98th St, Bloomington, MN 55420
Phone: 952-885-6060    
William Shaffer, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 7920 Old Cedar Ave S, Bloomington, MN 55425
Phone: 952-428-1800    
Donald L Zogg, MD
Internal Medicine
Medicare: Medicare Enrolled
Practice Location: 5705 W Old Shakopee Rd, Bloomington, MN 55437
Phone: 612-871-1145    
Randy Kimpell, MD
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 7920 Old Cedar Ave S, Bloomington, MN 55425
Phone: 952-851-1000    
Jonathan D. Katz, MD
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 600 W 98th St, Bloomington, MN 55420
Phone: 952-885-6060    

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