Individual provider Active NPI

Robert North Gibson, P.A.

  • Physician Assistant
  • Santa Ana, CA
National Provider Identifier
1457634008
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21862 Issued in CA
Practice address
3801 S Harbor Blvd
Santa Ana, CA 92704-7901
Phone
(714) 751-5555
Fax
(714) 751-9999
NPI assigned
Sep 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5892 AZ
Physician Assistant 363A00000X PA21862 CA Primary

Addresses

Primary practice location

3801 S Harbor Blvd
Santa Ana, CA 92704-7901

Mailing address

20422 Mooncrest Cir
Huntington Beach, CA 92646-4748
Phone (714) 390-2072

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120423000289 CA Practitioner - Physician Assistant 4789845538 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HMTS IncGroup PAC ID 1951750413, 118 clinicians

Practice addresses (Care Compare)

1190 Baker St
Suite 105
Costa Mesa, CA 92626-4105
Phone (714) 477-8460

15000 Kensington Park Dr
Suite 170
Tustin, CA 92782-1836
Phone (714) 477-8300

16205 Sand Canyon Ave
Suite 100
Irvine, CA 92618-3781
Phone (949) 557-0000

19582 Beach Blvd
Suite 180
Huntington Beach, CA 92648-5978
Phone (714) 477-8050

21115 Newport Coast Dr
Newport Beach, CA 92657-1122
Phone (949) 557-0730

26671 Aliso Creek Rd
Suite 101
Aliso Viejo, CA 92656-4807
Phone (949) 791-3107

49000 Barranca Pkwy
Suite 103
Irvine, CA 92604-8603
Phone (949) 791-3106

5341 Warner Ave
Huntington Beach, CA 92649-4078
Phone (714) 477-8450

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
21862CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Mar 1, 2017 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Mar 1, 2017 Accepting new patients
Hoag Hospital Past Accepting new patients
Ucxtra Umbrella, LLC Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1457634008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20422 MOONCREST CIR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926464748",
            "telephone_number": "714-390-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S HARBOR BLVD",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047901",
            "telephone_number": "714-751-5555",
            "fax_number": "714-751-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "ROBERT",
        "middle_name": "NORTH",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5892",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.