Mark Alan Gibson, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

MD28156 Issued in OR

Practice address

545 NE 47TH Ave Ste 215
Portland, OR 97213-2237

Phone

(503) 731-2900

NPI assigned

Dec 13, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Diagnostic RadiologyAlso: Interventional Radiology

Education

Indiana University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Radiology Specialists of the Northwest PCGroup PAC ID 6204829963, 28 clinicians

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
• Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318
• Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
• Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Providence Health & Services Oregon

  dba Providence Medical Group

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Radiology Specialists of the Northwest, PC

  • Diagnostic Radiology Physician
  • Portland, OR
  • NPI 1699759498
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Medical Oncology Physician
  • Portland, OR
  • NPI 1700166782
  NPD
• Providence Health & Services Oregon

  dba Providence Medical Group

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Clinic/Center
  • Portland, OR
  • NPI 1326272741

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Willamette Falls Medical Center

  • General Acute Care Hospital
  • Oregon City, OR
  • NPI 1912282369
  Care Compare affiliation
• Providence Health & Services Oregon

  dba Providence Hood River Memorial Hospital

  • Critical Access Hospital
  • Hood River, OR
  • NPI 1255429338
  Care Compare affiliation
• Providence Health & Services Oregon

  dba Providence Milwaukie Hospital

  • General Acute Care Hospital
  • Milwaukie, OR
  • NPI 1366536963
  Care Compare affiliation

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

{
    "created_epoch": "1229126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1710122106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 NE 47TH AVE STE 215",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132237",
            "telephone_number": "503-731-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 NE 47TH AVE STE 215",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132237",
            "telephone_number": "503-731-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-13",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OR",
            "license": "MD28156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larissa Gibson
• Lindsey Erin Gibson, MED
• Lisa Camille Gibson, RN BSN
• Madeline Jane Gibson
• Margaret Gibson, OTD, OTR/L
• Nancy Marie Gibson, FNP
• Owen Gibson, M.A.
• Richard F Gibson, MD
• Rosemary Gibson, CD(DONA)
• Samantha Gibson, CRM

• Vascular & Interventional Radiology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Vascular & Interventional Radiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.

Verify at the official NPI Registry.