Shanshan Elissa Gustafson, in Gaithersburg, MD

Shanshan Elissa Gustafson, is a medicare enrolled "Internal Medicine" physician in Gaithersburg, Maryland. Her current practice location is 655 Watkins Mill Rd Fl 5, Gaithersburg, Maryland. You can reach out to her office (for appointments etc.) via phone at (240) 632-4021.

Shanshan Elissa Gustafson is licensed to practice in Maryland (license number D0097815) 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 1417537259.

Contact Information

	Shanshan Elissa Gustafson,
	655 Watkins Mill Rd Fl 5, Gaithersburg, MD 20879-3301
	(240) 632-4021
	Not Available

Map and Direction

Physician's Profile

Full Name	Shanshan Elissa Gustafson
Gender	Female
Speciality	Internal Medicine
Location	655 Watkins Mill Rd Fl 5, Gaithersburg, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417537259
Provider Enumeration Date: 04/14/2021
Last Update Date: 06/25/2024

Medicare PECOS Information:

PECOS PAC ID: 4486056074
Enrollment ID: I20210702002720

Medical Identifiers

Medical identifiers for Shanshan Elissa Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417537259	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	D0097815 (Maryland)	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. Shanshan Elissa Gustafson allows following entities to bill medicare on her behalf.

Entity Name	Kaiser Foundation Health Plan Of The Mid-atlantic States, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952461816 PECOS PAC ID: 3779495858 Enrollment ID: O20040105000308

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. Shanshan Elissa 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 Address	Practice Location Address
Shanshan Elissa Gustafson, 655 Watkins Mill Rd Fl 5, Gaithersburg, MD 20879-3301 Ph: (240) 632-4021	Shanshan Elissa Gustafson, 655 Watkins Mill Rd Fl 5, Gaithersburg, MD 20879-3301 Ph: (240) 632-4021

Reviews and Comments

Internal Medicine Doctors in Gaithersburg, MD

Diane Mukherjee, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 7 Metropolitan Ct Ste 1, Gaithersburg, MD 20878 Phone: 240-773-0300
Dr. Kathleen Frekko Farrell, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 818 West Diamond Avenue, Ste 130, Gaithersburg, MD 20878 Phone: 301-948-8780 Fax: 301-519-9093
Dr. Alan Vinitsky, M.D Internal Medicine Medicare: May Accept Medicare Assignments Practice Location: 902 Wind River Ln Ste 201, Gaithersburg, MD 20878 Phone: 301-840-0002 Fax: 301-417-0262
Qiufang Cheng, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 16009 Comprint Cir, Gaithersburg, MD 20877 Phone: 301-339-8264 Fax: 301-339-8257
Miranda Kai Hunter, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 655 Watkins Mill Rd, Gaithersburg, MD 20879 Phone: 240-813-8740
Dr. Tuanh Tonnu, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 9057 Shady Grove Ct, Gaithersburg, MD 20877 Phone: 301-721-1614 Fax: 301-721-1624
Dr. Suhair A Abulfarag, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 604 S Frederick Ave Ste 413, Gaithersburg, MD 20877 Phone: 301-330-4414 Fax: 301-216-1637

Shanshan Elissa Gustafson, - Medicare Internal Medicine in Gaithersburg, MD