DR. JAMES ARTHUR GIBSON M.D.
NPI 1104838655
Internal Medicine in Waterford, MI

Q: What is James Gibson's NPI number?

The NPI number for James Gibson is 1104838655. It was assigned to this individual provider in the NPPES registry on August 13, 2006.

Q: What is James Gibson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for James Gibson was last updated on September 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.

Active since August 13, 2006PECOS EnrolledAccepts Medicare Assignment

5784 HIGHLAND RD, WATERFORD, MI 48327(248) 673-6667(248) 673-7234 Get Directions Write a Review

NPPES record last updated: September 23, 2016. Verified against the NPPES registry weekly; last sync: August 30, 2026.

On this page

About Dr. James Arthur Gibson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAMES ARTHUR GIBSON M.D. (NPI 1104838655) is an individual internal medicine provider in Waterford, Michigan, licensed in Michigan (4301065590) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence Hospital, Southfield And Novi, and is a graduate of Wayne State University School Of Medicine (1995).

NPPES Registry Identity

NPI1104838655

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. JAMES ARTHUR GIBSONCredential: M.D.

Location Address5784 HIGHLAND RDWaterford, MI 48327-1876

Mailing Address5784 Highland RdWaterford, MI 48327-1876 · (248) 673-6667 · Fax (248) 673-7234

Phone(248) 673-6667

Fax(248) 673-7234

Sole ProprietorNo

Medical School CMSWayne State University School Of MedicineGraduated 1995

Enumeration DateAugust 13, 2006

Last NPPES UpdateSeptember 23, 2016

✔ NPI 1104838655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MI · 4301065590

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

5784 HIGHLAND RD, Waterford, MI 48327

Open in Google Maps ↗

Other Identifiers 2

Medicare UPING73046MI

Medicare PIN0N83880MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. James Arthur Gibson M.d. 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.

PECOS PAC ID8426947896

PECOS Enrollment IDI20040407000866

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1019382

James A Gibson MD PC · Waterford, MI

Expired · Aug 15, 2026

CLIA Number23D1019382

Laboratory TypePhysician Office

Certificate Effective DateAugust 16, 2024

Certificate Expiration DateAugust 15, 2026

Laboratory DirectorJames A. Gibson

Laboratory Phone(248) 673-6667

Laboratory LocationJames A Gibson MD PC5784 Highland Rd, Waterford, MI 48327

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 17

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

656 services259 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

374 services192 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

367 services367 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

362 services362 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

256 services128 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

107 services63 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

91 services27 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

81 services54 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

73 services19 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

65 services65 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

57 services57 patients

Urine microalbumin (protein) level 82043

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

53 services53 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

52 services52 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

49 services44 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

40 services37 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

20 services16 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

14 services14 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension Providence Hospital, Southfield And Novi

Acute Care Hospitals · Southfield, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230019

Location16001 W Nine Mile RdSouthfield, MI 48075 · Oakland County

Emergency services Birthing friendly

Trinity Health Oakland Hospital

Acute Care Hospitals · Pontiac, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230029

Location44405 Woodward AvePontiac, MI 48341 · Oakland County

Emergency services Birthing friendly

Trinity Health Ann Arbor Hospital

Acute Care Hospitals · Ann Arbor, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230156

Location5301 E Huron River DrAnn Arbor, MI 48106 · Washtenaw County

Emergency services Birthing friendly

Mclaren Oakland

Acute Care Hospitals · Pontiac, MI

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230207

Location50 N Perry StPontiac, MI 48342 · Oakland County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48327 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$134.28 typical visit price

range $58.04 – $177.36

Typical copayment $33.57 (range $14.51 – $44.34)

Most-billed visit code 99204

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)

Percentage of patients, aged 18 years and older, with a diagnosis of acute viral sinusitis who were prescribed an antibiotic within 10 days after onset of symptoms

Lower rates are better for this measure.

96%264 patients1/55-star benchmark: 100%

Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)

Percentage of patients aged 18 years and older with a diagnosis of acute sinusitis who had a computerized tomography (CT) scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis

Lower rates are better for this measure.

0%242 patients

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

90%857 patients4/55-star benchmark: 100%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

80%853 patients4/55-star benchmark: 85%

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

63%171 patients3/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

98%10,144 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

78%898 patients4/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

95%438 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

94%1,543 patients4/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

25%1,543 patients2/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

33%1,509 patients2/55-star benchmark: 88%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

79%1,543 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

41%1,543 patients2/55-star benchmark: 89%

Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older

Percentage of female patients aged 65 years and older with a diagnosis of urinary incontinence with a documented plan of care for urinary incontinence at least once within 12 months

79%121 patients

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

44%1,543 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

12 suppliers49 claims118 services$5.80 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers22 claims29 services$1.07 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers17 claims18 services$4.78 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

4 suppliers55 claims56 services$182.32 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES A. GIBSON, M.D., P.C.

Internal Medicine

5784 HIGHLAND RD
WATERFORD, MI 48327

Oakland County (248) 673-6667

MRS. LAURA ELIZABETH SYCHTA N.P.

Nurse Practitioner (Family)

5784 HIGHLAND RD
WATERFORD, MI 48327

Oakland County (248) 673-6667

MOSHARRAF U. AHMED M.D. PC

Internal Medicine

5784 HIGHLAND RD, SUITE A
WATERFORD, MI 48327

Oakland County (248) 673-7202

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 James Gibson's NPI number?

The NPI number for James Gibson is 1104838655. It was assigned to this individual provider in the NPPES registry on August 13, 2006.

Where is James Gibson located?

James Gibson practices at 5784 Highland Rd, Waterford, MI 48327. The listed phone number is (248) 673-6667.

What is James Gibson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is James Gibson enrolled in Medicare?

Yes. James Gibson 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.

What insurance does James Gibson accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list James Gibson 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 James Gibson affiliated with any hospitals?

According to CMS data, James Gibson is affiliated with Ascension Providence Hospital, Southfield And Novi, Trinity Health Oakland Hospital, Trinity Health Ann Arbor Hospital and Mclaren Oakland.

When was this NPI record last updated?

The NPPES record for James Gibson was last updated on September 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.

About Dr. James Arthur Gibson M.d. NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 2

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare Enrollment Status

CLIA Laboratory Certificates CMS CLIA

Certificate of Waiver · 23D1019382

Areas of Expertise CMS Part B claims 17

Hospital Affiliations CMS Care Compare 4

Ascension Providence Hospital, Southfield And Novi

Trinity Health Oakland Hospital

Trinity Health Ann Arbor Hospital

Mclaren Oakland

Physician Visit Costs CMS claims · ZIP area

Medicare Quality Performance CMS QPP · MIPS

Reported Quality Measures

Referred Medical Equipment & Supplies CMS DME claims 4

Other Providers at the Same Location NPPES 3

Frequently Asked Questions NPPES & CMS

What is James Gibson's NPI number?

Where is James Gibson located?

What is James Gibson's specialty?

Is James Gibson enrolled in Medicare?

What insurance does James Gibson accept?

Is James Gibson affiliated with any hospitals?

When was this NPI record last updated?

Certificate of Waiver 23D1019382