MARY TERESA GIBSON ACNPC-AG
NPI 1144916297
Surgery - Trauma Surgery in Goodyear, AZ

Active since April 12, 2023PECOS Enrolled
13677 W MCDOWELL RD, GOODYEAR, AZ 85395(623) 853-3832 Get Directions Write a Review

NPPES record last updated: April 12, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mary Teresa Gibson Acnpc-ag NPPES

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

MARY TERESA GIBSON ACNPC-AG (NPI 1144916297) is an individual trauma surgery provider in Goodyear, Arizona, licensed in Arizona (290448) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1144916297
Entity TypeIndividualFemale
Primary Taxonomy2086S0127X
Provider Legal NameMARY TERESA GIBSONCredential: ACNPC-AG
Location Address13677 W MCDOWELL RDGoodyear, AZ 85395-2635
Mailing Address14175 W Indian School Rd Ste B4Goodyear, AZ 85395-8494 · (623) 853-3832
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateApril 12, 2023
NPPES CertifiedApril 12, 2023
✔ NPI 1144916297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Trauma SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0127X
License✔ Licensed in AZ · 290448
Definition
Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.
13677 W MCDOWELL RD, Goodyear, AZ 85395

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Teresa Gibson Acnpc-ag is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5496250672
PECOS Enrollment IDI20250926003487
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.

Medicare Billing Reassignment

Medicare enrollment records show Mary Gibson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Trauma Surgery
13555 W MCDOWELL RD STE 204
Goodyear, AZ 85395
  • Reassigned Medicare billing, Arizona enrollment
  • 10 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.

Other Providers at the Same Location NPPES 20

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

Internal Medicine (Cardiovascular Disease)
13677 W MCDOWELL RD
GOODYEAR, AZ 85395
Student in an Organized Health Care Education/Training Program
13677 W MCDOWELL RD
GOODYEAR, AZ 85395
Student in an Organized Health Care Education/Training Program
13677 W MCDOWELL RD
GOODYEAR, AZ 85395
Student in an Organized Health Care Education/Training Program
13677 W MCDOWELL RD
GOODYEAR, AZ 85395
Nurse Anesthetist, Certified Registered
13677 W MCDOWELL RD
GOODYEAR, AZ 85395
Pediatrics (Neonatal-Perinatal Medicine)
13677 W MCDOWELL RD
GOODYEAR, AZ 85395
Student in an Organized Health Care Education/Training Program
13677 W MCDOWELL RD
GOODYEAR, AZ 85395
Physician Assistant
13677 W MCDOWELL RD
GOODYEAR, AZ 85395

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 Mary Gibson's NPI number?

The NPI number for Mary Gibson is 1144916297. It was assigned to this individual provider in the NPPES registry on April 12, 2023.

Where is Mary Gibson located?

Mary Gibson practices at 13677 W Mcdowell Rd, Goodyear, AZ 85395. The listed phone number is (623) 853-3832.

What is Mary Gibson's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Trauma Surgery, with taxonomy code 2086S0127X.

Is Mary Gibson enrolled in Medicare?

Yes. Mary Gibson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Gibson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Gibson reassigns Medicare benefits to Surgicalist Of Az PLLC (Goodyear, AZ). The 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 Mary Gibson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Gibson was last updated on April 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.