Jennifer Gustafson, OT is a medicare enrolled "Occupational Therapist" provider in Claremont, South Dakota. Her current practice location is
12057 411th Ave, Claremont, South Dakota. You can reach out to her office (for appointments etc.) via phone at
(605) 290-1163.
Jennifer Gustafson is licensed to practice in South Dakota (license number 0487) 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 1578717112.
Healthcare Provider's Profile
| Full Name | Jennifer Gustafson |
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| Gender | Female |
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| Speciality | Occupational Therapist |
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| Location | 12057 411th Ave, Claremont, South Dakota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1578717112
- Provider Enumeration Date: 11/10/2008
- Last Update Date: 01/12/2022
Medicare PECOS Information:
- PECOS PAC ID: 3173832870
- Enrollment ID: I20221108002174
Medical Identifiers
Medical identifiers for Jennifer Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1578717112 | NPI | - | NPPES |
| 1041741 | Other | SD | CERTIFICATION |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | 0487 (South Dakota) | 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. Jennifer Gustafson allows following entities to bill medicare on her behalf.
| Provider Name | Modern Day Health Care Prof Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1851883540
PECOS PAC ID: 8325473507
Enrollment ID: O20200116000301 |
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| Provider Name | Brain Intercept Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1881296861
PECOS PAC ID: 3476960519
Enrollment ID: O20210407002186 |
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| Provider Name | Prairie Independence Pllc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1306597232
PECOS PAC ID: 9133596018
Enrollment ID: O20221107000331 |
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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. Jennifer 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 |
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Jennifer Gustafson, OT
12057 411th Ave,
Claremont, SD 57432-7302
Ph: (605) 290-1163 | Jennifer Gustafson, OT
12057 411th Ave,
Claremont, SD 57432-7302
Ph: (605) 290-1163 |
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