Individual provider Active NPI

Xunda A. Gibson, M.D.

  • Internal Medicine Physician
  • Miami Gardens, FL
National Provider Identifier
1205879202
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A83389 Issued in CA
Practice address
17940 NW 27TH Ave
Miami Gardens, FL 33056-3505
Phone
(305) 621-8899
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME89553 FL
Internal Medicine Physician 207R00000X 2771 VI
Internal Medicine Physician 207R00000X A83389 CA Primary

Addresses

Primary practice location

17940 NW 27TH Ave
Miami Gardens, FL 33056-3505

Mailing address

2436 N Federal Hwy Ste 229
Lighthouse Point, FL 33064-6854
Phone (561) 543-0616

Other identifiers 4

IdentifierTypeStateIssuer
270783700MedicaidFL
270783703MedicaidFL
35070OtherFLBCBS
P00322676OtherRR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VI, CA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20041110001172 FL Practitioner - Internal Medicine 0345203279 Reassigns benefits to 2 organizations
I20191014002557 VI Practitioner - Internal Medicine 0345203279 Reassigns benefits to 2 organizations
I20200423002443 CA Practitioner - Internal Medicine 0345203279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4000 Beeston Hill Medical Ctr
Suite 11
Christiansted, VI 00820-5254
Phone (561) 543-0616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A83389CAMDInternal Medicine Physician
ME89553FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Hospitalists of Florida, LLC CurrentSince Jan 10, 2021 Accepting new patients
Eastside Hospitalists Inc CurrentSince Jul 15, 2021 Accepting new patients
Hospitalist Medicine Physicians of California, Inc Internal Medicine CurrentSince Mar 1, 2023 Accepting new patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Aug 15, 2019 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Dec 1, 2023 Accepting new patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Aug 15, 2019 Accepting new patients
Galen Inpatient Physicians Inc Internal Medicine CurrentSince Dec 1, 2023 Accepting new patients
Galen Inpatient Physicians, PC Current Accepting new patients
Sports Medicine Grant, Inc Past Accepting new patients
QMC LLC PastSince Feb 1, 2021 Accepting new patients

Locations

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

3600 Washington St
Hollywood, FL 33021
Phone (954) 265-4461

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423

Interoperability endpoints

  • Direct secure messaging: xunda.gibson.p1@direct.bondclinicpa.nextgenshare.com

Organizations & group practices 11

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1205879202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2436 N FEDERAL HWY STE 229",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330646854",
            "telephone_number": "561-543-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17940 NW 27TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330563505",
            "telephone_number": "305-621-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "XUNDA",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME89553",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VI",
            "license": "2771",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A83389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270783700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270783703",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35070",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00322676",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

Verify at the official NPI Registry.