Individual provider Active NPI

Jeffrey S. Gibbs, M.D.

  • Cardiovascular Disease Physician
  • Seattle, WA
National Provider Identifier
1285623736
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD00043538 Issued in WA
Practice address
1101 Madison St
Suite 301
Seattle, WA 98104-1306
Phone
(206) 505-1101
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD00043538 WA Primary

Addresses

Primary practice location

1101 Madison St
Suite 301
Seattle, WA 98104-1306

Mailing address

1101 Madison St
Suite 301
Seattle, WA 98104-1306
Phone (206) 505-1101

Other identifiers 1

IdentifierTypeStateIssuer
8390320MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040520000365 WA Practitioner - Internal Medicine 1052302908 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00043538WAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
International Community Health Services Current Accepting new patients
International Community Health Services CurrentSince Apr 9, 2025 Accepting new patients
Prairie Cardiovascular Consultants LTD Cardiovascular Disease Past Accepting new patients

Locations

3815 S Othello St
Fl 2
Seattle, WA 98118
Phone (206) 788-3500

720 8th Ave S
Seattle, WA 98104
Phone (206) 788-3770

Organizations & group practices 3

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285623736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST",
            "address_2": "SUITE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041306",
            "telephone_number": "206-505-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST",
            "address_2": "SUITE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041306",
            "telephone_number": "206-505-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "JEFFREY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00043538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8390320",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.