NPIMap

Individual provider Active NPI

Patrick R. Gibson, PA-C, MHP

  • Medical Physician Assistant
  • Enfield, CT
National Provider Identifier
1861406597
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5858 Issued in CT
Practice address
701 Enfield St
Enfield, CT 06082-2961
Phone
(860) 741-6058
Fax
(413) 733-5860
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5858 CT Primary
Physician Assistant 363A00000X 510 MA
Physician Assistant 363A00000X PA510 MA

Addresses

Primary practice location

701 Enfield St
Enfield, CT 06082-2961

Mailing address

280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-5700

Other identifiers 1

IdentifierTypeStateIssuer
110165973AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081120000571 MA Practitioner - Physician Assistant 0446310437 Reassigns benefits to 1 organization
I20221230000747 CT Practitioner - Physician Assistant 0446310437 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians
Springfield Medical Associates, Inc.Group PAC ID 6103725452, 10 clinicians

Practice addresses (Care Compare)

701 Enfield St
Enfield, CT 06082-2961
Phone (860) 741-6058

701 Enfield St
Suite 100
Enfield, CT 06082-2977
Phone (860) 741-6058

Hospital & facility affiliations

  • Comfort Plus Caregivers LLC Home health agency, East Longmeadow, MA, CCN 227707
  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077
  • Baystate Noble Hospital Hospital, Westfield, MA, CCN 220065
  • Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
510MAMDAudiologist
5858CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc CurrentSince Aug 15, 2016 Accepting new patients
Baystate Medical Practices, Inc Past Accepting new patients
Mwa, PC Past Accepting new patients

Locations

444 Montgomery St
Chicopee, MA 01020
Phone (413) 594-3111

305 Bicentennial Hwy
Springfield, MA 01118
Phone (413) 733-4101

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

395 Southampton Rd
Ste 100
Westfield, MA 01085
Phone (413) 485-4661

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1861406597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST FL 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 ENFIELD ST",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060822961",
            "telephone_number": "860-741-6058",
            "fax_number": "413-733-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "PATRICK",
        "middle_name": "R.",
        "credential": "PA-C, MHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "5858",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "510",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA510",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110165973A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.