Active NPI
Olga Gibbons, M.D.
- Family Medicine Physician
- Palm Beach Gardens, FL
National Provider Identifier
1689636268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME114917
- Practice address
- 3385 Burns Rd Ste 203
Palm Beach Gardens, FL 33410-4328 - Phone
- (561) 768-7886
- Fax
- (561) 627-3991
- NPI assigned
- Apr 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 161590 | NY | |
| Family Medicine Physician | 207Q00000X | ME114917 | FL | Primary |
Addresses
Primary practice location
3385 Burns Rd Ste 203
Palm Beach Gardens, FL 33410-4328
Mailing address
601 University Blvd Ste 104
Jupiter, FL 33458-2788
Phone (561) 768-7886
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014685500-EFF 4/9/15 | Medicaid | FL | |
| DV3514-P01508770 | Other | FL | RAILROAD MEDICARE- |
| 00930176 | Medicaid | NY | |
| 01468550 | Medicaid | FL | |
| 60D241 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557446400000",
"number": "1689636268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 UNIVERSITY BLVD STE 104",
"city": "JUPITER",
"state": "FL",
"postal_code": "334582788",
"telephone_number": "561-768-7886",
"fax_number": "561-627-3991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3385 BURNS RD STE 203",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334104328",
"telephone_number": "561-768-7886",
"fax_number": "561-627-3991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBONS",
"first_name": "OLGA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-06",
"last_updated": "2019-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "161590",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME114917",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014685500-EFF 4/9/15",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE-",
"identifier": "DV3514-P01508770",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00930176",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01468550",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60D241",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Beach Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.