Individual provider Active NPI

Ryan Charles Gibbons, M.D.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1467570143
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD454664 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-5030
Fax
(215) 707-3494
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD454664 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-5030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MT, DE, TX4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20150708001040 PA Practitioner - Emergency Medicine 4880906676 Reassigns benefits to 3 organizations
I20240207003990 MT Practitioner - Emergency Medicine 4880906676
I20240405002808 DE Practitioner - Emergency Medicine 4880906676 Reassigns benefits to 2 organizations
I20240724001983 TX Practitioner - Emergency Medicine 4880906676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Temple University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-5030

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD454664PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS Naihs Chinle Comprehensive CurrentSince Jul 8, 2024 Accepting new patients
Christiana Care Health Services Inc Emergency Medicine CurrentSince Aug 4, 2025 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 11, 2019 Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Feb 7, 2024 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Emergency Care Specialists, PC Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility Current Accepting new patients
Central Montana Medical Facilities, Inc. Current Accepting new patients
Christiana Care Emergency Physicians LLC Emergency Medicine CurrentSince Mar 3, 2024 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Jul 8, 2024 Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Feb 7, 2024 Accepting new patients
Christiana Care Health Services Inc CurrentSince Aug 4, 2025 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Mar 11, 2019 Accepting new patients
Central Montana Medical Facilities, Inc. Past Accepting new patients

Locations

621 Middletown Odessa Rd
Middletown, DE 19709
Phone (302) 203-1300

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

408 Wendell Ave
Lewistown, MT 59457
Phone (406) 535-1502

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

2601 Holme Ave
Philadelphia, PA 19152
Phone (215) 335-6000

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

100 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 707-1200

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

701 E Marshall St
West Chester, PA 19380
Phone (610) 431-5000

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 8

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1467570143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-5030",
            "fax_number": "215-707-3494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-5030",
            "fax_number": "215-707-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "RYAN",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD454664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.