DR. JOHN WILLIAM GILBOY MD
NPI 1093210171
Internal Medicine - Pulmonary Disease in South Portland, ME
About Dr. John William Gilboy Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JOHN WILLIAM GILBOY MD (NPI 1093210171) is an individual pulmonary disease provider in South Portland, Maine, licensed in Maine (MD28023) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS, is affiliated with Northern Light Health, and maintains a secondary practice location in Farmington.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. John William Gilboy Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
5Medicare enrollment records show John Gilboy reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Cape Elizabeth, ME 04107
- Reassigned Medicare billing, Maine enrollment
- 3,140 clinicians in this Medicare group
Portland, ME 04102
- Reassigned Medicare billing, Maine enrollment
- 322 clinicians in this Medicare group
South Portland, ME 04106
- Reassigned Medicare billing, Maine enrollment
- 40 clinicians in this Medicare group
Machias, ME 04654
- Reassigned Medicare billing, Maine enrollment
- 83 clinicians in this Medicare group
Calais, ME 04619
- Reassigned Medicare billing, Maine enrollment
- 43 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Northern Light Health
Acute Care Hospitals · Portland, MEMaine Medical Center
Acute Care Hospitals · Portland, MECentral Maine Medical Center
Acute Care Hospitals · Lewiston, MEStephens Memorial Hospital
Critical Access Hospitals · Norway, MEMemorial Hospital, The
Critical Access Hospitals · North Conway, NHPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 04106 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is John Gilboy's NPI number?
The NPI number for John Gilboy is 1093210171. It was assigned to this individual provider in the NPPES registry on March 29, 2018.
Where is John Gilboy located?
John Gilboy practices at Chest Medicine Associates 100 Foden Road Suite 103, South Portland, ME 04106. The listed phone number is (207) 828-1122.
What is John Gilboy's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.
Is John Gilboy enrolled in Medicare?
Yes. John Gilboy is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for John Gilboy's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Gilboy reassigns Medicare benefits to 5 organizations: Mainehealth (Cape Elizabeth, ME), Mercy Hospital (Portland, ME), Chest Medicine Associates, PA (South Portland, ME), Down East Community Hospital (Machias, ME) and Calais Community Hospital (Calais, ME). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Gilboy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does John Gilboy accept?
Health plans from Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care and Taro Health list John Gilboy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is John Gilboy affiliated with any hospitals?
According to CMS data, John Gilboy is affiliated with Northern Light Health, Maine Medical Center, Central Maine Medical Center, Stephens Memorial Hospital and Memorial Hospital, The.
When was this NPI record last updated?
The NPPES record for John Gilboy was last updated on January 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. John William Gilboy, MD · NPI 1093210171
Pulmonary Disease physician in South Portland, Maine. Individual provider, active in the CMS NPPES registry since March 29, 2018.
## Identity
- **NPI:** 1093210171 (Entity type: Individual)
- **Enumerated:** March 29, 2018
- **Primary specialty:** Internal Medicine - Pulmonary Disease · taxonomy 207RP1001X
- **State license:** MD28023 (Maine)
- **Sole proprietor:** No
## Practice location
- **Address:** CHEST MEDICINE ASSOCIATES, 100 FODEN ROAD SUITE 103, South Portland, ME 04106-3134
- **Phone:** (207) 828-1122
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Mainehealth (NPI 1619281698, Cape Elizabeth, ME); Mercy Hospital (NPI 1629078712, Portland, ME); Chest Medicine Associates, PA (NPI 1437255247, South Portland, ME); Down East Community Hospital (NPI 1528087004, Machias, ME); Calais Community Hospital (NPI 1922001049, Calais, ME) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Tufts University School Of Medicine, class of 2018
## Record status
- **NPPES last updated:** January 7, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1093210171) · Data from the CMS NPPES public registry.