Active NPI 1558306373 Individual Practitioner Male Practitioner

Ty C. Gulstrom , PA-C

Physician Assistant • Mount Vernon, WA

Professional Overview & Biography Verified Profile Summary

Ty Gulstrom, PA-C is a registered healthcare professional specializing in Physician Assistant in Mount Vernon, WA. Practice services are available at 1400 E. KINCAID STREET under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, urinalysis, manual test. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1400 E. Kincaid Street

Mount Vernon, WA 982744127

Telephone 3604286434

Fax 3608484233

Associated Practice Facility / Clinic

🏢 Public Hospital Dist No 1 Skagit Facility NPI 1295774016

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Mount Vernon, WA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 14.8 Yrs

State Avg: 12.1 Yrs

Regional Practice Density

24 Specialists

Practicing in Mount Vernon, WA (3774 Statewide)

Telehealth Adoption Rate

8.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

76.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	239	196	$328.09	$79.51
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	190	188	$405.01	$98.18
81002 Urinalysis, manual test	39	35	$74.49	$3.41
71046 X-ray of chest, 2 views	22	20	$89.01	$22.42
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	18	16	$51.98	$12.59
69209 Removal of impacted ear wax by washing	15	15	$58.28	$15.06
73630 X-ray of foot, minimum of 3 views	14	14	$100.52	$27.12
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$600.67	$145.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	38	38	$146.05	$88.06
99213 Established patient office or other outpatient visit, typically 15 minutes	13	13	$103.69	$59.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	113	111	$127.68	$69.58
99213 Established patient office or other outpatient visit, typically 15 minutes	33	31	$76.00	$44.53
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	31	31	$127.03	$65.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	19	$111.00	$68.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	149	144	$114.89	$66.44
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	78	77	$111.00	$67.30
99213 Established patient office or other outpatient visit, typically 15 minutes	43	43	$79.37	$43.64
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	33	33	$117.39	$66.35
99213 Established patient office or other outpatient visit, typically 15 minutes	21	20	$76.00	$43.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	164	162	$116.27	$67.24
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	100	99	$111.00	$66.97
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	39	39	$131.21	$67.20
99213 Established patient office or other outpatient visit, typically 15 minutes	38	37	$78.82	$43.63
99213 Established patient office or other outpatient visit, typically 15 minutes	27	27	$75.00	$43.10
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$113.00	$65.38

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	247	237	$116.06	$66.33
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	146	140	$111.00	$66.13
99213 Established patient office or other outpatient visit, typically 15 minutes	35	35	$76.23	$43.37
99213 Established patient office or other outpatient visit, typically 15 minutes	31	31	$73.00	$42.83
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	29	29	$124.69	$66.04
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$179.56	$107.86
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$113.00	$64.32

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License WA PA10004348

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Emergency Medicine

NUCC Taxonomy Code: 207P00000X

State License WA PA10004348

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

State License WA PA10004348

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

8386484 (WA)

Commercial Insurance / Payer ID Bswa

3479GU (WA)

Commercial Insurance / Payer ID Usdlab

605960012

Commercial Insurance / Payer ID Liwa

0216864 (WA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

22 Associated Practitioners

Dr. Sandra Gailey , MD

Emergency Medicine

NPI 1013930197

Doctor of Medicine (M.D.)

Lisa Kohler , ARNP

Nurse Practitioner - Family

NPI 1083699771

Advanced Registered Nurse Practitioner

Dr. Anirban Das , DO

Family Medicine

NPI 1083889190

Doctor of Osteopathic Medicine (D.O.)

Sherry Peterson , ARNP

Nurse Practitioner - Family

NPI 1134368988

Advanced Registered Nurse Practitioner

Rae Boyd , APRN

Nurse Practitioner - Family

NPI 1144225236

Advanced Practice Registered Nurse

Dr. Elizabeth Repplier , MD

Family Medicine

NPI 1285698803

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active February 18, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location February 18, 2015

Registered at 1400 E. KINCAID STREET, MOUNT VERNON, WA 982744127 (Tel: 3604286434)

📍

Updated Business Mailing Address February 18, 2015

Registered at 1400 E. KINCAID STREET, ATTN: CREDENTIALING, MOUNT VERNON, WA 982744127 (Tel: 3604282500)

👤

Provider Name / Credentials Updated February 18, 2015

Recorded as TY GULSTROM, PA- C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 18, 2015

Emergency Medicine (License #PA10004348 in WA)

🟢

Initial NPI Registration & Enumeration June 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1558306373

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 17, 2006

Last Update: February 18, 2015

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1400 E. Kincaid Street, Attn: Credentialing

Mount Vernon, WA 982744127

Phone: 3604282500

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.