Individual provider Active NPI

Edward F Gibbons, MD

  • Cardiovascular Disease Physician
  • Seattle, WA
National Provider Identifier
1144294232
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD00022606 Issued in WA
Practice address
325 9TH Ave
Seattle, WA 98104-2420
Phone
(206) 744-3475
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 89019 SC
Cardiovascular Disease Physician 207RC0000X 66586 AZ
Cardiovascular Disease Physician 207RC0000X CDR.0001690 CO
Cardiovascular Disease Physician 207RC0000X T7108 TX
Cardiovascular Disease Physician 207RC0000X 91964 GA
Cardiovascular Disease Physician 207RC0000X 2023-00965 NC
Cardiovascular Disease Physician 207RC0000X MD00022606 WA Primary

Addresses

Primary practice location

325 9TH Ave
Seattle, WA 98104-2420

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 543-6420

Other practice location 1

1600 E Jefferson St Ste 600
Seattle, WA 98122-5649
Phone (206) 215-4545

Other identifiers 2

IdentifierTypeStateIssuer
0039571OtherWAL&I
1144294232MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MI, NE, LA, ND, VT, MT, MN, MD, IL, NV, CT12 enrollments
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 12

Enrollment IDStateProvider typePAC IDDetails
I20050203000758 WA Practitioner - Cardiovascular Disease (Cardiology) 5799736013 Reassigns benefits to 1 organization
I20220504001339 MI Practitioner - Cardiovascular Disease (Cardiology) 5799736013
I20220504001397 NE Practitioner - Cardiovascular Disease (Cardiology) 5799736013
I20220506001459 LA Practitioner - Cardiovascular Disease (Cardiology) 5799736013
I20220510001781 ND Practitioner - Cardiovascular Disease (Cardiology) 5799736013
I20220511000625 VT Practitioner - Cardiovascular Disease (Cardiology) 5799736013
I20220511000657 MT Practitioner - Cardiovascular Disease (Cardiology) 5799736013
I20220512000771 MN Practitioner - Cardiovascular Disease (Cardiology) 5799736013
I20220520000302 MD Practitioner - Cardiovascular Disease (Cardiology) 5799736013 Reassigns benefits to 1 organization
I20220617000089 IL Practitioner - Cardiovascular Disease (Cardiology) 5799736013
I20220623003433 NV Practitioner - Cardiovascular Disease (Cardiology) 5799736013
I20220916002698 CT Practitioner - Cardiovascular Disease (Cardiology) 5799736013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Chicago, Pritzker School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Movn Health Medical Group PLLCGroup PAC ID 8123423563, 8 clinicians

Practice addresses (Care Compare)

221 1St Ave W
Suite 200
Seattle, WA 98119-4223
Phone (833) 426-6686

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318452NYMDLicensed Practical Nurse
CDR.0001690COMDCardiovascular Disease Physician
2023-00965NCMDCardiovascular Disease Physician
89019SCMDCardiovascular Disease Physician
MD00022606WAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Movn Health Medical Group PLLC Cardiovascular Disease CurrentSince Jul 1, 2024 Accepting new patients

Locations

3415 S Sepulveda Blvd
Ste 1168
Los Angeles, CA 90034

3415 S Sepulveda Blvd
Ste 1140
Los Angeles, CA 90034

279 Central Ave
Albany, NY 12206

401 Park Ave S
Fl 10
New York, NY 10016
Phone (347) 252-9771

221 1st Ave W
Ste 200
Seattle, WA 98119
Phone (832) 400-1002

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBIAED/Endpoint/EBIAED

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1144294232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-543-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042420",
            "telephone_number": "206-744-3475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 E Jefferson St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981225649",
            "country_code": "US",
            "telephone_number": "206-215-4545",
            "fax_number": "206-215-4550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "EDWARD",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "89019",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "66586",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "CDR.0001690",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "T7108",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "91964",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2023-00965",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00022606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0039571",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144294232",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.