Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Maxine Rae Gustafson, PA-C

Individual provider Physician Assistant · NPI 1083127203

Maxine Rae Gustafson, PA-C is a Physician Assistant in Edina, Minnesota. Qualified in 2017, 9 years ago. Practices with Minnesota Urology, PA, a 82-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
9
Licensed in
MN
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6525 France Ave S Ste 200
Edina, MN 55435-2176
Phone: (952) 927-6501
Fax: (952) 653-1433
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12582 (MN)

Record details

NPI number1083127203
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 9, 2017
Last updated in NPPESNovember 9, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Minnesota Urology, Pa — 82 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Edina