Active NPI
Jessica Leigh Gibson, PSYD, LP
- Psychologist
- Newton, MA
National Provider Identifier
1275023921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 11339
- Practice address
- 1340 Centre St Ste 209
Newton, MA 02459-2453 - Phone
- (617) 354-4450
- Fax
- (617) 354-4452
- NPI assigned
- May 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 11339 | MA | Primary |
Addresses
Primary practice location
1340 Centre St Ste 209
Newton, MA 02459-2453
Mailing address
1340 Centre St Ste 209
Newton, MA 02459-2453
Phone (617) 354-4450
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 16, 2026 through Jun 16, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11339 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jessica Gibson LLC | Current | Accepting new patients | |
| Optum Behavioral Care of Connecticut, P.C. | Past | Accepting new patients |
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.
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- Waltham, MA
- NPI 1316636988
-
- Clinical Social Worker
- Providence, RI
- NPI 1730972944
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675296000000",
"number": "1275023921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 CENTRE ST STE 209",
"city": "NEWTON",
"state": "MA",
"postal_code": "024592453",
"telephone_number": "617-354-4450",
"fax_number": "617-354-4452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 CENTRE ST STE 209",
"city": "NEWTON",
"state": "MA",
"postal_code": "024592453",
"telephone_number": "617-354-4450",
"fax_number": "617-354-4452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JESSICA",
"middle_name": "LEIGH",
"name_prefix": "Dr.",
"credential": "PSYD, LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-17",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "11339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.