Individual provider Active NPI

Devyn Gibby, DO

  • Family Medicine Physician
  • San Clemente, CA
National Provider Identifier
1811632409
Registry record updated Aug 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A24264 Issued in CA
Practice address
993 Avenida Pico Ste 110
San Clemente, CA 92673-3908
Phone
(949) 557-0820
NPI assigned
Apr 28, 2022
Last updated
Aug 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 20A24264 CA Primary

Addresses

Primary practice location

993 Avenida Pico Ste 110
San Clemente, CA 92673-3908

Mailing address

993 Avenida Pico Ste 110
San Clemente, CA 92673-3908
Phone (949) 557-0820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20251001002112 CA Practitioner - Family Practice 0244750685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia Col of Osteo Med, Sewanee, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hoag ClinicGroup PAC ID 3274872064, 447 clinicians

Practice addresses (Care Compare)

1031 Avenida Pico
Suite 204
San Clemente, CA 92673-6352
Phone (949) 829-5533

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A24264CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Hospital Past Accepting new patients
Inspira Health Network Medical Group, P.C. Multi-Specialty Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755907200000",
    "number": "1811632409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "993 AVENIDA PICO STE 110",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926733908",
            "telephone_number": "949-557-0820",
            "fax_number": "949-557-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "993 AVENIDA PICO STE 110",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926733908",
            "telephone_number": "949-557-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBY",
        "first_name": "DEVYN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-28",
        "last_updated": "2025-08-23",
        "certification_date": "2025-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A24264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.