Doctor profile · Federal record

Dr. Shane Gustafson, DO

Sports Medicine (Family Medicine) Physician (CMS: Sports Medicine) · Sports Medicine (Family Medicine) Physician · Bloomington, MN

  • NPI 1922017623
  • Accepts Medicare
  • 23 yrs in practice
  • Licensed in 2 states
  • Male
  • Group practice
  • No sanctions

Practice & contact

Operates at 2 locations .

NPPES Updated May 11, 2026
Primary practice
8100 Northland Dr
Bloomington, MN 554314800
(952) 831-8742
Additional location
1901 Connecticut Ave S
Sartell, MN 56377
(320) 229-2118
fax (320) 259-8044
Mailing address
8170 33Rd Ave S # MS 21110Q
Bloomington, MN 554254516

Credentials & registration

NPPES · NUCC
NPI registered
August 2006 — 20 yrs on file
Profile last updated
June 17, 2021
Year of graduation
2003 — 23 yrs since
Specialty taxonomy
207QS0010X — NUCC code
State licenses (2)
Minnesota #50252 · Ohio #34-008344
Medicaid
MN #935408000

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1922017623. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
1,272
Distinct HCPCS
8
Medicare allowed
$54,437
HCPCS Description Services Patients Avg allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 820 92 $1
99214 Established patient office or other outpatient visit, 30-39 minutes 104 87 $123
99213 Established patient office or other outpatient visit, 20-29 minutes 72 55 $87
99215 Established patient office or other outpatient visit, 40-54 minutes 69 68 $167
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance 57 40 $107
99204 New patient office or other outpatient visit, 45-59 minutes 55 55 $158
20610 Aspiration and/or injection of fluid from large joint 54 46 $68
99203 New patient office or other outpatient visit, 30-44 minutes 41 41 $109

In context: peer comparison

Among 5 peers in this city , average services per provider: 183. This provider delivers 7.0× the peer median.

Medicare Part D · 2023

Top prescriptions

CMS Part D Prescriber
Total claims
190
Patients
153
Total drug cost
$1,439
Drug Type Claims Patients Total cost
Methylprednisolone Generic 55 55 $629
Cyclobenzaprine Hcl Generic 39 34 $193
Tramadol Hcl Generic 34 23 $117
Oxycodone-Acetaminophen (Oxycodone Hcl/Acetaminophen) Brand 33 17 $329
Hydrocodone-Acetaminophen (Hydrocodone/Acetaminophen) Brand 29 24 $172

Frequently asked questions

Auto-generated from federal data
What is Dr. Shane Gustafson's medical specialty?
Dr. Shane Gustafson practices Sports Medicine (Family Medicine) Physician in Bloomington, MN.
Where does Dr. Shane Gustafson practice?
Dr. Shane Gustafson practices at 8100 Northland Dr, Bloomington, MN 554314800. Office phone: 9528318742.
What is Dr. Shane Gustafson's NPI?
Dr. Shane Gustafson's National Provider Identifier (NPI) is 1922017623, issued by NPPES.
Does Dr. Shane Gustafson accept Medicare assignment?
Yes. Dr. Shane Gustafson accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Shane Gustafson commonly perform?
Top Medicare-reported procedures in 2023: Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS J3301); Established patient office or other outpatient visit (HCPCS 99214); Established patient office or other outpatient visit (HCPCS 99213). Source: CMS Medicare Physician & Other Practitioners file.