Individual provider Active NPI

Eliot Gibbs

  • Family Medicine Physician
  • Webster, NY
National Provider Identifier
1497163091
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
290338 Issued in NY
Practice address
2000 Empire Blvd
Webster, NY 14580-1957
Phone
(585) 922-0930
Fax
(585) 787-2533
NPI assigned
Jul 27, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 290338 NY Primary

Addresses

Primary practice location

2000 Empire Blvd
Webster, NY 14580-1957

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-0553

Other practice location 1

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-4163

Other identifiers 1

IdentifierTypeStateIssuer
04919004MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20171206002409 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative MedicinePractitioner - Hospitalist 0941567580 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Mar 1, 2019 Accepting new patients
Western New York Medical Practice P.C. Family Medicine CurrentSince Mar 1, 2019 Accepting new patients
Wellbe New York Medical PC CurrentSince Sep 1, 2024 Accepting new patients
Rochester General Hospital Family Medicine CurrentSince Mar 1, 2019 Accepting new patients

Locations

225 W Washington St
Ste 1500
Chicago, IL 60606
Phone (312) 776-2422

1156 6th Ave
New York, NY 10036
Phone (312) 776-2410

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

2000 Empire Blvd
Webster, NY 14580
Phone (585) 922-0374

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.

NPI Registry JSON

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

{
    "created_epoch": "1406419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1497163091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 EMPIRE BLVD",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145801957",
            "telephone_number": "585-922-0930",
            "fax_number": "585-787-2533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Montauk Hwy",
            "address_purpose": "LOCATION",
            "city": "West Islip",
            "state": "NY",
            "postal_code": "117954927",
            "country_code": "US",
            "telephone_number": "631-376-4163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "ELIOT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-27",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "290338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04919004",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, NY

Sources for this page

Verify at the official NPI Registry.