Active NPI
Michael Kent Gilbertson, LCSW
- Clinical Social Worker
- Klamath Falls, OR
National Provider Identifier
1952442980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L3264
- Practice address
- 1900 Main St Ste B
Klamath Falls, OR 97601-2629 - Phone
- (541) 884-9890
- Fax
- (541) 884-9890
- NPI assigned
- Feb 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L3264 | OR | Primary |
Addresses
Primary practice location
1900 Main St Ste B
Klamath Falls, OR 97601-2629
Mailing address
1900 Main St Ste B
Klamath Falls, OR 97601-2629
Phone (541) 884-9890
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111019000953 | OR | Practitioner - Clinical Social Worker | 9931193166 | Practice locations: Klamath Falls, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1900 Main St
Suite B
Klamath Falls, OR 97601-2629
Phone (541) 884-9890
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L3264 | OR | MD | Clinical Social Worker |
| 3264 | OR | MD | Interpreter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580860800000",
"number": "1952442980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 MAIN ST STE B",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976012629",
"telephone_number": "541-884-9890",
"fax_number": "541-884-9890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 MAIN ST STE B",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976012629",
"telephone_number": "541-884-9890",
"fax_number": "541-884-9890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILBERTSON",
"first_name": "MICHAEL",
"middle_name": "KENT",
"name_prefix": "Dr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-11",
"last_updated": "2020-02-05",
"certification_date": "2020-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L3264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Klamath Falls, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.