Daniel Peter Gibson, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

M-17359 Issued in ID

Practice address

333 N 1St St Ste 250
Boise, ID 83702-6132

Phone

(208) 381-9384

Fax

(208) 381-9385

NPI assigned

Nov 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

95.75 of 100Reported as group

Promoting interoperability

95

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: daniel.gibson.p1@direct.goodmancampbell.nextgenshare.com

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.

• Ascension Medical Group-Southeast Wisconsin Inc

  dba Ascension Medical Group

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077

  Diagnostic Radiology

  Medicare reassignment NPD
• Columbia St. Mary'S Hospital Milwaukee, Inc

  dba Ascension Columbia St Mary's Hospital Milwaukee

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482
  Medicare reassignment NPD
• Milwaukee Radiologists LTD

  • Diagnostic Radiology Physician
  • Greenfield, WI
  • NPI 1568564904
  Medicare reassignment
• Columbia St. Mary'S Hospital Milwaukee Inc

  dba Ascension Columbia St Mary's Hospital Ozaukee

  • Psychiatric Hospital Unit
  • Mequon, WI
  • NPI 1417600909
  NPD
• Columbia St. Mary'S Hospital Milwaukee, Inc

  dba Ascension Columbia St Mary's Hospital Milwaukee

  • Multi-Specialty Clinic/Center
  • Glendale, WI
  • NPI 1215945456
  NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1952477929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13345 ILLINOIS ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323318",
            "telephone_number": "317-396-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N 1ST ST STE 250",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026132",
            "telephone_number": "208-381-9384",
            "fax_number": "208-381-9385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 N Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532114508",
            "country_code": "US",
            "telephone_number": "414-585-3223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13345 Illinois St",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460323318",
            "country_code": "US",
            "telephone_number": "317-396-1300",
            "fax_number": "317-352-3417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "DANIEL",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "WI",
            "license": "65310",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "65310",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WI",
            "license": "65310",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "ID",
            "license": "M-17359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M-17359",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q006012",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony P Giauque, M.D.
• Emily Anne Gibbons, PHARMD
• Patricia Lyn Gibbons, CRNA
• Shelby Kaitlyn Gibbons, PA-C
• Terri L Gibbs, DC
• Elizabeth A Gibson, LCPC
• Lisa Jillian Gibson
• Michael P Gibson, MD
• Patricia Gibson
• Robb F Gibson, M.D.

• Vascular & Interventional Radiology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Vascular & Interventional Radiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.