Individual provider Active NPI

Kathryn Gibbs, DO

  • Spinal Cord Injury Medicine Physician
  • Syracuse, NY
National Provider Identifier
1063856631
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Spinal Cord Injury Medicine PhysicianTaxonomy code 2081P0004X
License
277467 Issued in NY
Practice address
800 Irving Ave
Syracuse, NY 13210-2716
Phone
(315) 425-4400
NPI assigned
Apr 25, 2013
Last updated
Nov 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Spinal Cord Injury Medicine Physician 2081P0004X 277467 NY Primary

Addresses

Primary practice location

800 Irving Ave
Syracuse, NY 13210-2716

Mailing address

800 Irving Ave
Syracuse, NY 13210-2716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210430001588 NY Practitioner - Physical Medicine and Rehabilitation 2163758251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.72 of 100Reported as group
Quality
89.22
Promoting interoperability
100
Improvement activities
40
Cost
77.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
277467NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine & Rehab Medical Service Group CurrentSince May 1, 2021 Accepting new patients

Locations

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

750 E Adams St
Fl 2
Syracuse, NY 13210
Phone (315) 464-2296

800 Irving Ave
Syracuse, NY 13210
Phone (315) 425-6515

813 Fay Rd
Syracuse, NY 13219
Phone (315) 464-5820

Organizations & group practices 1

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": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1063856631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102716",
            "telephone_number": "315-425-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "KATHRYN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-25",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "NY",
            "license": "277467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.