Samuel W Gibson, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

52665 Issued in WI

Practice address

700 S Park St
Madison, WI 53715-1830

Phone

(608) 251-6100

Fax

(608) 826-2710

NPI assigned

Jun 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Diagnostic Radiology

Education

University of Iowa, RJ & L Carver College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Madison Radiologists S CGroup PAC ID 1951209311, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083
• The Monroe Clinic Hospital, Monroe, WI, CCN 520028
• Sauk Prairie Hospital Hospital, Prairie Du Sac, WI, CCN 520095
• SSM Health St Clare Hospital - Baraboo Hospital, Baraboo, WI, CCN 520057
• Reedsburg Area Medical Center Hospital, Reedsburg, WI, CCN 521351

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dean Health Systems, Inc

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846
  Medicare reassignment Care Compare group NPD
• Madison Radiologists S C

  • Diagnostic Radiology Physician
  • Madison, WI
  • NPI 1871573725
  Medicare reassignment Care Compare group
• Beloit Radiology LTD

  • Diagnostic Radiology Physician
  • Beloit, WI
  • NPI 1386661734
  Medicare reassignment NPD
• Radiology Associates of the Fox Valley, SC

  • Diagnostic Radiology Physician
  • Neenah, WI
  • NPI 1477539443
  Medicare reassignment NPD
• Dean Health Systems, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

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

• Reedsburg Area Medical Center, Inc.

  • Family Medicine Physician
  • Reedsburg, WI
  • NPI 1457780983

  Hospital

  Care Compare affiliation
• Reedsburg Area Medical Center, Inc.

  • Critical Access Hospital
  • Reedsburg, WI
  • NPI 1891796710
  Care Compare affiliation
• Sauk Prairie Healthcare Inc

  • General Acute Care Hospital
  • Prairie Du Sac, WI
  • NPI 1861466153
  Care Compare affiliation
• SSM Health Care of Wisconsin Inc

  • General Acute Care Hospital
  • Baraboo, WI
  • NPI 1386641207
  Care Compare affiliation
• SSM Health Care of Wisconsin, Inc.

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1184621211
  Care Compare affiliation
• The Monroe Clinic, Inc.

  • General Acute Care Hospital
  • Monroe, WI
  • NPI 1740291491
  Care Compare affiliation

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1386840742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-251-6100",
            "fax_number": "608-826-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-251-6100",
            "fax_number": "608-826-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SAMUEL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "68620",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2008011534",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "52665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386840742",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colleen Gibson, APNP
• Kyle Mark Gibson, MS, ATC
• Lilian Gibson, MD
• Maya Gibson, RD
• Michael Gibson, M.D.
• William Edward Gibson IV, M.D.
• Barry E Gidal, PHARMD
• Natasha Giddens, MD
• Jean Gidlund, MA
• Jack Gieche, M.S.

• Diagnostic Radiology Physician in Madison, WI
• Providers in Madison, WI by specialty
• Diagnostic Radiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.