Individual provider Active NPI

Stacey Gibbons, MD

  • Anesthesiology Physician
  • Galveston, TX
National Provider Identifier
1124082250
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
T5325 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-5302
Phone
(409) 772-1221
Fax
(409) 772-1224
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 047596 GA
Anesthesiology Physician 207L00000X 41738 TX
Anesthesiology Physician 207L00000X T5325 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-5302

Mailing address

PO Box 650859
Dept 710
Dallas, TX 75265-0859
Phone (409) 747-6240

Other identifiers 2

IdentifierTypeStateIssuer
000921181EMedicaidGA
989896OtherGABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070926000970 TX Practitioner - Anesthesiology 6507870003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Boston University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

132 E Hospital Dr
Angleton, TX 77515-4112
Phone (979) 849-7721

140 E Hospital Dr
Angleton, TX 77515-4112
Phone (409) 772-2222

2020 E Hwy 6
Alvin, TX 77511-8507
Phone (281) 585-2530

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

Hospital & facility affiliations

  • University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018

Merit-based Incentive Payment System (MIPS)

Final score
78.88 of 100Reported as group
Quality
73.38
Improvement activities
40
Cost
78.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41738TXMDPharmacist
T5325TXMDAnesthesiology Physician
38425TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice Anesthesiology CurrentSince Sep 8, 2022 Accepting new patients
TMC-West Georgia Anesthesia Associates Inc. Anesthesiology Past Accepting new patients
Southern Crescent Anesthesiology, PC Anesthesiology Past Accepting new patients

Locations

2020 E Highway 6
Alvin, TX 77511
Phone (281) 585-2530

132 E Hospital Dr
Angleton, TX 77515
Phone (210) 629-3866

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

301 University Blvd
Fl 6
Galveston, TX 77555

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

2240 Gulf Fwy S
League City, TX 77573
Phone (832) 505-1000

200 Blossom St
Webster, TX 77598
Phone (281) 252-7000

Organizations & group practices 3

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 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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1124082250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650859",
            "address_2": "DEPT 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650859",
            "telephone_number": "409-747-6240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-1221",
            "fax_number": "409-772-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "STACEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "047596",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "41738",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "T5325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000921181E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "989896",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.