Active NPI
Peter Desmond Gibson
- Orthopaedic Hand Surgery Physician
- Flagstaff, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- 55699
- Practice address
- 107 E Oak Ave
Flagstaff, AZ 86001 - Phone
- (928) 779-7880
- NPI assigned
- Apr 2, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopaedic Hand Surgery Physician | 207XS0106X | 55699 | AZ | Primary |
Addresses
Primary practice location
107 E Oak Ave
Flagstaff, AZ 86001
Mailing address
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 213-6235
Other practice location 1
1485 N Turquoise Dr Ste 200
Flagstaff, AZ 86001
Phone (928) 774-7757
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 363405 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- 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 Compare- Specialty
- Orthopedic Surgery
- Education
- Virginia Commonwealth University, School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366
Hospital & facility affiliations
- Verde Valley Medical Center
- Flagstaff Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.13 of 100
- Quality
- 66.85
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 74.4
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Knee replacement | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 29 |
| Removal of tissue | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55699 | AZ | MD | Orthopaedic Hand Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Arizona Healthcare Corporation | Orthopaedic Surgery | Current | Accepting new patients |
| Flagstaff Pathology Associates | Current | Accepting new patients | |
| Northern Arizona Healthcare Corporation | Current | Accepting new patients |
Locations
269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251
450 S Willard St
Cottonwood, AZ 86326
Phone (928) 649-7991
1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249
1485 N Turquoise Dr
Ste 200
Flagstaff, AZ 86001
Phone (928) 774-7757
2000 S Thompson St
Flagstaff, AZ 86001
Phone (928) 213-1051
107 E Oak Ave
Flagstaff, AZ 86001
Phone (928) 779-7880
7810 N US Highway 89
Flagstaff, AZ 86004
Phone (928) 522-8375
107 E Oak Ave
Ste 101
Flagstaff, AZ 86001
Phone (928) 774-1811
1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235
107 E Oak Ave
Ste 101201
Flagstaff, AZ 86001
Phone (800) 656-7880
1485 N Turquoise Dr
Ste 220
Flagstaff, AZ 86001
Phone (928) 214-6626
200 Lee St
Winslow, AZ 86047
Phone (928) 226-6400
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.
-
- Family Medicine Physician
- Flagstaff, AZ
- NPI 1669914552
Orthopaedic Surgery
-
- Critical Access Hospital
- Winslow, AZ
- NPI 1477653889
-
- Anatomic Pathology & Clinical Pathology Physician
- Flagstaff, AZ
- NPI 1306205612
-
- Multi-Specialty Clinic/Center
- Flagstaff, AZ
- NPI 1235732702
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Flagstaff, AZ
- NPI 1649370875
-
- General Acute Care Hospital
- Flagstaff, AZ
- NPI 1780635078
-
- General Acute Care Hospital
- Cottonwood, AZ
- NPI 1346291648
-
- General Acute Care Hospital
- Sedona, AZ
- NPI 1538608716
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560816000000",
"number": "1861758096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N BEAVER ST",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013118",
"telephone_number": "928-213-6235",
"fax_number": "928-213-6292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 E OAK AVE",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "86001",
"telephone_number": "928-779-7880"
}
],
"practiceLocations": [
{
"address_1": "1485 N Turquoise Dr Ste 200",
"address_purpose": "LOCATION",
"city": "Flagstaff",
"state": "AZ",
"postal_code": "86001",
"country_code": "US",
"telephone_number": "928-774-7757",
"fax_number": "928-226-3071",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GIBSON",
"first_name": "PETER",
"middle_name": "DESMOND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-02",
"last_updated": "2019-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "AZ",
"license": "55699",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "363405",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.