Individual provider Active NPI

Joseph Gibbs

  • Cardiovascular Disease Physician
  • Detroit, MI
National Provider Identifier
1053654665
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301103399 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-1888
NPI assigned
Apr 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301103399 MI
Cardiovascular Disease Physician 207RC0000X 4301103399 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Detroit, MI 48202-2608

Other practice location 1

1391 E Parkdale Ave Ste 101
Manistee, MI 49660-9352
Phone (231) 398-1896

Other practice location 2

1200 Sixth St Ste 200
Traverse City, MI 49684-2369
Phone (231) 935-5800

Other practice location 3

1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-6370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20161017000477 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2163654229 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

1105 6TH St
Traverse City, MI 49684-2386

1121 6TH St
Suite 316
Traverse City, MI 49684-2345
Phone (231) 392-8280

1200 6TH St
Suite 200
Traverse City, MI 49684-2369
Phone (231) 935-5800

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Munson Healthcare Manistee Hospital Hospital, Manistee, MI, CCN 230303
  • Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301
  • Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center Internal Medicine CurrentSince Jul 19, 2021 Accepting new patients
Munson Medical Group Cardiovascular Disease CurrentSince Jul 19, 2021 Accepting new patients
Munson Medical Center CurrentSince Jul 19, 2021 Accepting new patients
Munson Medical Group CurrentSince Jul 19, 2021 Accepting new patients
Munson Medical Center Current Accepting new patients
Munson Healthcare Manistee Hospital PastSince Jul 19, 2021 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

2891 Momentum Pl
Chicago, IL 60689

1391 E Parkdale Ave
Ste 101
Manistee, MI 49660
Phone (231) 398-1840

1391 E Parkdale Ave
Ste 104
Manistee, MI 49660
Phone (231) 398-1710

1105 Sixth St
Ste 200
Traverse City, MI 49684

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1200 Sixth St
Ste 200
Traverse City, MI 49684

Interoperability endpoints

  • Direct secure messaging: jgibbs2@direct.mhc.net

Organizations & group practices 7

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

Hospital & facility affiliations 6

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": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1053654665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-1888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1391 E Parkdale Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Manistee",
            "state": "MI",
            "postal_code": "496609352",
            "country_code": "US",
            "telephone_number": "231-398-1896",
            "fax_number": "231-398-1894",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Sixth St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842369",
            "country_code": "US",
            "telephone_number": "231-935-5800",
            "fax_number": "231-935-5799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1105 Sixth St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842345",
            "country_code": "US",
            "telephone_number": "231-935-6370",
            "fax_number": "231-935-6451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-02",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301103399",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301103399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.