NPIMap

Individual provider Active NPI

Thomas Gibson, MD

  • Diagnostic Radiology Physician
  • Portland, OR
National Provider Identifier
1902196249
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD178927 Issued in OR
Practice address
9205 SW Barnes Rd
Portland, OR 97225
Phone
(503) 216-4830
Fax
(503) 216-4850
NPI assigned
Apr 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 178927 OR
Diagnostic Radiology Physician 2085R0202X MD178927 OR Primary

Addresses

Primary practice location

9205 SW Barnes Rd
Portland, OR 97225

Mailing address

PO Box 25180
Portland, OR 97298-0180
Phone (503) 797-6356

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160706002753 OR Practitioner - Diagnostic Radiology 9638322787 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Oregon Health Sciences University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Medical Imaging LLCGroup PAC ID 9335191543, 28 clinicians
Bridgeport Medical Imaging, LLCGroup PAC ID 3173670411, 28 clinicians
TRG, LLCGroup PAC ID 8820283617, 35 clinicians

Practice addresses (Care Compare)

10810 NE Cornell Rd
Suite 100
Hillsboro, OR 97124-9219
Phone (503) 216-8400

18040 Swlower Boones Ferry Rd
Suite 106
Tigard, OR 97224-7259
Phone (503) 216-8400

7305 SE Circuit Dr
Suite 170
Hillsboro, OR 97123-1915
Phone (503) 216-8400

810 12TH St
Hood River, OR 97031-1587
Phone (503) 292-9108

9205 SW Barnes Rd
Portland, OR 97225-6603

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Seaside Hospital Hospital, Seaside, OR, CCN 381303
  • Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
  • Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

Merit-based Incentive Payment System (MIPS)

Final score
45.93 of 100Reported as group
Quality
36.39
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.78 of 100Reported as group
Quality
100
Improvement activities
40
Cost
85.93

Merit-based Incentive Payment System (MIPS)

Final score
45.94 of 100Reported as group
Quality
36.41
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
178927ORMDDiagnostic Radiology Physician
MD178927ORMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jul 1, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2018 Accepting new patients
Bridgeport Medical Imaging, LLC Diagnostic Radiology CurrentSince Jul 16, 2018 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jul 1, 2018 Accepting new patients
TRG, LLC Diagnostic Radiology CurrentSince Jul 16, 2018 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jul 1, 2018 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2018 Accepting new patients
Center for Medical Imaging LLC Diagnostic Radiology CurrentSince Jul 16, 2018 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jul 1, 2018 Accepting new patients

Locations

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

10810 NE Cornell Rd
Ste 100
Hillsboro, OR 97124
Phone (503) 216-4399

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

18040 SW Lower Boones Ferry Rd
Ste 106
Tigard, OR 97224
Phone (503) 216-8400

Organizations & group practices 11

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": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1902196249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25180",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972980180",
            "telephone_number": "503-797-6356",
            "fax_number": "503-292-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-216-4830",
            "fax_number": "503-216-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-07",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "178927",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD178927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.