Shanshan Elissa Gustafson, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in San Francisco, California. She went to Drexel University College Of Medicine and graduated in 2021 and has 5 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc and her current practice location is
2425 Geary Blvd, San Francisco, California. You can reach out to her office (for appointments etc.) via phone at
(415) 833-2000.
Shanshan Elissa Gustafson is licensed to practice in * (Not Available) (license number ) 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 1417537259.
Physician's Profile
| Full Name | Shanshan Elissa Gustafson |
|---|
| Gender | Female |
|---|
| Speciality | Internal Medicine |
|---|
| Experience | 5 Years |
|---|
| Location | 2425 Geary Blvd, San Francisco, California |
|---|
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Shanshan Elissa Gustafson attended and graduated from Drexel University College Of Medicine in 2021
NPI Data:
- NPI Number: 1417537259
- Provider Enumeration Date: 04/14/2021
- Last Update Date: 04/07/2025
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) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc | 3779495858 | 1793 |
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,
2425 Geary Blvd,
San Francisco, CA 94115-3358
Ph: () - | Shanshan Elissa Gustafson,
2425 Geary Blvd,
San Francisco, CA 94115-3358
Ph: (415) 833-2000 |
Reviews and Comments