Individual provider Active NPI

Meliseanna Katerina Elizabeth Gibbons, MD

  • Internal Medicine Physician
  • Milford, DE
National Provider Identifier
1124511167
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C1-0024358 Issued in DE
Practice address
101 Wellness Way Ste 200
Milford, DE 19963-4366
Phone
(302) 430-0867
Fax
(302) 430-0421
NPI assigned
Jun 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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 C1-0024358 DE Primary

Addresses

Primary practice location

101 Wellness Way Ste 200
Milford, DE 19963-4366

Mailing address

640 S. State Street, Mail Code 3055
Dover, DE 19901-3530
Phone (302) 480-1688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20210907000370 DE Practitioner - Internal Medicine 6204232945 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bayhealth Medical Center, IncGroup PAC ID 1658364740, shared by 16 NPIs, 399 clinicians

Practice addresses (Care Compare)

101 Wellness Way
200 Bayhealth Primary Care Sussex
Milford, DE 19963-4366
Phone (302) 430-0867

804 N Dupont Blvd
Bayhealth Internal Med.Milford Kent
Milford, DE 19963-1006
Phone (302) 725-3557

Hospital & facility affiliations

  • Bayada Home Health Care at Bayhealth Home health agency, Dover, DE, CCN 087024
  • Aveanna Home Healthcare Home health agency, Milford, DE, CCN 087039
  • Bayhealth Hospital, Sussex Campus Hospital, Milford, DE, CCN 080009
  • Bayhealth Medical Center, Kent Campus Hospital, Dover, DE, CCN 080004
  • Beebe Medical Center Hospital, Lewes, DE, CCN 080007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc. Current Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Oct 22, 2023 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Sep 27, 2021 Accepting new patients
Bayhealth Medical Center, Inc Internal Medicine CurrentSince Sep 27, 2021 Accepting new patients

Locations

640 S State St
#3055
Dover, DE 19901
Phone (302) 480-1688

640 S State St
Dover, DE 19901
Phone (302) 744-4700

804 N DuPont Blvd
Milford, DE 19963
Phone (302) 725-3557

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

101 Wellness Way
Ste 200
Milford, DE 19963
Phone (302) 422-1251

Organizations & group practices 4

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 5

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": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1124511167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE STREET, MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WELLNESS WAY STE 200",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199634366",
            "telephone_number": "302-430-0867",
            "fax_number": "302-430-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "MELISEANNA",
        "middle_name": "KATERINA ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0024358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

Verify at the official NPI Registry.