NPIMap

Individual provider Active NPI

Gerald P Gibbons Jr., M.D.

  • Internal Medicine Physician
  • Wilkes Barre, PA
National Provider Identifier
1336147883
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD020226E Issued in PA
Practice address
1620 Highway 315 Blvd Ste 1
Wilkes Barre, PA 18702-7125
Phone
(570) 237-5444
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD020226E PA Primary

Addresses

Primary practice location

1620 Highway 315 Blvd Ste 1
Wilkes Barre, PA 18702-7125

Mailing address

1620 Highway 315 Blvd Ste 1
Wilkes Barre, PA 18702-7125
Phone (570) 237-5444

Other practice location 1

1099 S Township Blvd
Pittston, PA 18640-3247
Phone (570) 654-6759 ext. 2

Other identifiers 6

IdentifierTypeStateIssuer
001188OtherPAFIRST PRIORITY HEALTH
0006032010001MedicaidPA
020338000OtherPABLACK LUNG
12039 E222OtherPAGEISINGER HEALTH PALN
020316OtherPAHIGHMARK BLUE SHIELD
020316OtherPAFIRST PRIORITY LIFE INS C

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gerald.gibbons.1@21771.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081013000291 PA Practitioner - Internal Medicine 6800975368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1620 Hwy 315 Blvd
Suite 1
Wilkes Barre, PA 18702-7125
Phone (570) 336-1733

Hospital & facility affiliations

  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137
  • Chestnut Hill Rehabilitation and Healthcare Center Nursing home, Wilkes Barre, PA, CCN 395148

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gerald Gibbons MD LLC Internal Medicine CurrentSince Jul 8, 2023 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Cancer Center of Lewisburg CurrentSince Jan 1, 2008 Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2008 Accepting new patients

Locations

439 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-1444

100 N Academy Ave
Danville, PA 17822

1099 S Township Blvd
Pittston, PA 18640
Phone (570) 602-2400

1620 Highway 315 Blvd
Ste 1
Wilkes Barre, PA 18702
Phone (570) 237-5444

Interoperability endpoints

  • Direct secure messaging: gerald.gibbons.1@29162.direct.athenahealth.com

Organizations & group practices 4

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1336147883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 HIGHWAY 315 BLVD STE 1",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027125",
            "telephone_number": "570-237-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 HIGHWAY 315 BLVD STE 1",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027125",
            "telephone_number": "570-237-5444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1099 S Township Blvd",
            "address_purpose": "LOCATION",
            "city": "Pittston",
            "state": "PA",
            "postal_code": "186403247",
            "country_code": "US",
            "telephone_number": "570-654-6759 x2",
            "fax_number": "570-883-7446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "GERALD",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD020226E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "001188",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006032010001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "020338000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PALN",
            "identifier": "12039 E222",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "020316",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY LIFE INS C",
            "identifier": "020316",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gerald.gibbons.1@21771.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1099 S Township Blvd",
            "city": "Pittston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "186403247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.