Individual provider Active NPI

Eileen Frances Gibbons, M.D.

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1184792178
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34303 Issued in WA
Practice address
1325 4TH Ave
Suite 1240
Seattle, WA 98101-2573
Phone
(206) 625-0202
Fax
(206) 625-1910
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34303 WA Primary

Addresses

Primary practice location

1325 4TH Ave
Suite 1240
Seattle, WA 98101-2573

Mailing address

1325 4TH Ave
Suite 1240
Seattle, WA 98101-2573
Phone (206) 625-0202

Other identifiers 2

IdentifierTypeStateIssuer
1102110MedicaidWA
34303OtherWAMD LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20040503001277 WA Practitioner - Family Practice 3870580731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 1994
Medicare assignment
May accept Medicare assignment
Group practices
American Current Care of Washington PSGroup PAC ID 8022356617, 17 clinicians

Practice addresses (Care Compare)

2624 S 38TH St
Tacoma, WA 98409-7308
Phone (253) 475-5908

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34303WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Washington, P.S. Current Accepting new patients
American Current Care of Washington, P.S. CurrentSince Feb 12, 2019 Accepting new patients

Locations

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

1925 140th Ave NE
Bellevue, WA 98005
Phone (425) 865-8060

3101 111th St SW
Unit Tu
Everett, WA 98204
Phone (425) 267-0299

9222 N Newport Hwy
Ste 1
Spokane, WA 99218
Phone (509) 467-4545

2624 S 38th St
Tacoma, WA 98409
Phone (253) 473-1585

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184792178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 4TH AVE",
            "address_2": "SUITE 1240",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012573",
            "telephone_number": "206-625-0202",
            "fax_number": "206-625-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 4TH AVE",
            "address_2": "SUITE 1240",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012573",
            "telephone_number": "206-625-0202",
            "fax_number": "206-625-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "EILEEN",
        "middle_name": "FRANCES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "34303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1102110",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE NUMBER",
            "identifier": "34303",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.