Individual provider Active NPI

Robert B Gibson, M.D.

  • Cardiovascular Disease Physician
  • Leesburg, FL
National Provider Identifier
1962848382
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME139276 Issued in FL
Practice address
511 Medical Plaza Dr Ste 101
Leesburg, FL 34748-7328
Phone
(352) 728-6808
Fax
(352) 728-1743
NPI assigned
May 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN18479 FL
Cardiovascular Disease Physician 207RC0000X ME139276 FL Primary

Addresses

Primary practice location

511 Medical Plaza Dr Ste 101
Leesburg, FL 34748-7328

Mailing address

511 Medical Plaza Dr Ste 101
Leesburg, FL 34748-7328
Phone (352) 728-6808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20190613000544 FL Practitioner - Cardiovascular Disease (Cardiology) 7810125606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
East Tennessee State University Quillen College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1414 Kuhl Ave
Orlando, FL 32806-2008
Phone (407) 841-5111

Hospital & facility affiliations

  • Pinnacle Home Care of the Villages Inc Home health agency, The Villages, FL, CCN 109702
  • Uf Health Leesburg Hospital Hospital, Leesburg, FL, CCN 100084
  • Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN18479FLMDInternal Medicine Physician
ME139276FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jan 1, 2021 Accepting new patients

Locations

511 Medical Plaza Dr
Ste 101
Leesburg, FL 34748

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1560 Santa Barbara Blvd
The Villages, FL 32159
Phone (352) 750-5000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rgibson33527@orlandohealth.medalliesdirect.net
  • Direct secure messaging: rgibson564269@direct.shands.ufl.edu

Organizations & group practices 3

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": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1962848382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 MEDICAL PLAZA DR STE 101",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487328",
            "telephone_number": "352-728-6808",
            "fax_number": "352-728-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 MEDICAL PLAZA DR STE 101",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487328",
            "telephone_number": "352-728-6808",
            "fax_number": "352-728-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "ROBERT",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-13",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN18479",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME139276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.