Samuel A Gibson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA000263L Issued in PA

Practice address

11277 Vernon Place
Suite 200
Meadville, PA 16335-3717

Phone

(814) 724-1252

NPI assigned

Jul 10, 2006

Last updated

May 3, 2016By the provider in NPPES

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 OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352

Merit-based Incentive Payment System (MIPS)

Final score

83.94 of 100Reported as group

Quality

71.12

Promoting interoperability

100

Improvement activities

40

Cost

75.36

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Triad Health Services, LLC

  dba Southwoods Physician Services

  • Plastic Surgery Physician
  • Youngstown, OH
  • NPI 1588925457
  Medicare reassignment Care Compare group
• Ernest W. Swanson, M.D.

  dba The Orthopaedic Center of Western PA

  • Orthopaedic Surgery Physician
  • Hermitage, PA
  • NPI 1689862229
  NPD (past)
• Southwoods Health at Home, LLC

  • Home Health Agency
  • Youngstown, OH
  • NPI 1023788940
  NPD (past)
• The Surgery Center at Southwoods, LLC

  dba The Surgical Hospital at Southwoods

  • Special Hospital
  • Youngstown, OH
  • NPI 1740398890
  NPD (past)

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

• The Surgery Center at Southwoods, LLC

  dba The Surgical Hospital at Southwoods

  • Special Hospital
  • Youngstown, OH
  • NPI 1740398890
  Care Compare affiliation

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1881628311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11277 VERNON PLACE",
            "address_2": "SUITE 200",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353717",
            "telephone_number": "814-724-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11277 VERNON PLACE",
            "address_2": "SUITE 200",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353717",
            "telephone_number": "814-724-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SAMUEL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA000263L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Gellman
• Robert E George, DC
• Amanda Gerard
• Ggnsc Meadville LP (Golden LivingCenter - Meadville)
• Brian Gibbs
• Bridget Starr Gill, CRNP
• Atifa Gillani
• Susan Gizzie, LPC
• Brittany Glass-Moran, LPC NCC CAADC CCTP
• Christopher Glecos, DMD

• Physician Assistant in Meadville, PA
• Providers in Meadville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; 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.