Individual provider Active NPI

Derrick Christian Gibson

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1003519018
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1025626 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-5775
NPI assigned
Mar 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1025626 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

75 Francis St
Boston, MA 02115-6106
Phone (617) 732-5775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260523000145 MA Practitioner - Internal Medicine 4688119597

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical Branch at Galveston, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, shared by 5 NPIs, 2,931 clinicians

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1025626MAMDInternal Medicine Physician

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1003519018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "617-732-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "DERRICK",
        "middle_name": "CHRISTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "1025626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.