Individual provider Active NPI

Jessilyn Gibas

  • Physical Therapist
  • Wells, ME
National Provider Identifier
1023624269
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7206 Issued in ME
Practice address
45 Wells PLZ Ste 10
Wells, ME 04090-4146
Phone
(207) 641-2292
NPI assigned
Sep 22, 2020
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.025477 IL
Physical Therapist 225100000X 2305216863 VA
Physical Therapist 225100000X 05015741A IN
Physical Therapist 225100000X PT7206 ME Primary

Addresses

Primary practice location

45 Wells PLZ Ste 10
Wells, ME 04090-4146

Mailing address

45 Wells PLZ Ste 10
Wells, ME 04090-4146

Other practice location 1

6300 Kingery Hwy Ste 204
Willowbrook, IL 60527-2326
Phone (630) 891-3980

Other practice location 2

1675 N National Rd Ste D
Columbus, IN 47201-5501
Phone (812) 799-1257

Other practice location 3

138 Stoneridge Dr N Ste 4
Ruckersville, VA 22968-3063
Phone (434) 985-2288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN, VA, ME4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20211013001667 IL Practitioner - Physical Therapist in Private Practice 3577961002 Reassigns benefits to 2 organizations
I20240923004052 IN Practitioner - Physical Therapist in Private Practice 3577961002 Reassigns benefits to 1 organization
I20250317002133 VA Practitioner - Physical Therapist in Private Practice 3577961002 Reassigns benefits to 1 organization
I20250821001756 ME Practitioner - Physical Therapist in Private Practice 3577961002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

45 Wells PLZ
Unit 10
Wells, ME 04090-4146

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

Merit-based Incentive Payment System (MIPS)

Final score
85.3 of 100Reported as group
Quality
88.48
Improvement activities
40
Cost
72.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.025477ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Orthopedic Rehabilitation Institute,Inc Physical Therapist CurrentSince Jul 8, 2021 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc Physical Therapist Current Accepting new patients
Achieve Orthopedic Sports Institute, LLC CurrentSince Jul 8, 2021 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince Aug 3, 2025 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince Aug 3, 2025 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

7055 High Grove Blvd
Burr Ridge, IL 60527
Phone (630) 371-1623

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

9121 159th St
Orland Hills, IL 60487
Phone (630) 371-1623

760 Pasquinelli Dr
Ste 304
Westmont, IL 60559
Phone (630) 371-1623

6300 Kingery Hwy
Ste 204
Willowbrook, IL 60527
Phone (630) 891-3980

1675 N National Rd
Ste D
Columbus, IN 47201
Phone (812) 799-1257

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

400 North St
#2
Saco, ME 04072
Phone (207) 282-7121

45 Wells Plz
Ste 10
Wells, ME 04090
Phone (207) 641-2292

45 Wells Plz
Unit 10
Wells, ME 04090
Phone (207) 641-2292

2275 Beech Ave
Buena Vista, VA 24416
Phone (540) 466-1000

138 Stoneridge Dr N
Ste 4
Ruckersville, VA 22968
Phone (434) 985-2288

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1023624269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WELLS PLZ STE 10",
            "city": "WELLS",
            "state": "ME",
            "postal_code": "040904146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 WELLS PLZ STE 10",
            "city": "WELLS",
            "state": "ME",
            "postal_code": "040904146",
            "telephone_number": "207-641-2292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6300 Kingery Hwy Ste 204",
            "address_purpose": "LOCATION",
            "city": "Willowbrook",
            "state": "IL",
            "postal_code": "605272326",
            "country_code": "US",
            "telephone_number": "630-891-3980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1675 N National Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "IN",
            "postal_code": "472015501",
            "country_code": "US",
            "telephone_number": "812-799-1257",
            "fax_number": "812-799-1258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "138 Stoneridge Dr N Ste 4",
            "address_purpose": "LOCATION",
            "city": "Ruckersville",
            "state": "VA",
            "postal_code": "229683063",
            "country_code": "US",
            "telephone_number": "434-985-2288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBAS",
        "first_name": "JESSILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.025477",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216863",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05015741A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT7206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wells, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.