Active NPI
Eliot Gibbs
- Family Medicine Physician
- Webster, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 290338
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04919004 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 96.62 of 100
- 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rochester General Hospital | Current | Accepting new patients | |
| Western New York Medical Practice P.C. | Family Medicine | Current | Accepting new patients |
| Wellbe New York Medical PC | Current | Accepting new patients | |
| Rochester General Hospital | Family Medicine | Current | 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.
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- Rochester, NY
- NPI 1356412712
-
- Internal Medicine Physician
- Rochester, NY
- NPI 1902586712
-
- Family Medicine Physician
- Rochester, NY
- NPI 1063790608
-
- General Acute Care Hospital
- Rochester, NY
- NPI 1255360517
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.