DR. SEAN C GILBEY MD
NPI 1184628828
Internal Medicine - Critical Care Medicine in Austin, TX

Active since June 10, 2005PECOS Enrolled
80.78/100
CMS Quality Rating
5920 W WILLIAM CANNON DR, BLDG 1 STE 150, AUSTIN, TX 78749(512) 441-9799(512) 441-9814 Get Directions Write a Review

NPPES record last updated: October 24, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Sean C Gilbey Md NPPES

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

DR. SEAN C GILBEY MD (NPI 1184628828) is an individual critical care medicine provider in Austin, Texas, licensed in Texas (K6589) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and is a graduate of Indiana University School Of Medicine (1995).

NPPES Registry Identity

NPI1184628828
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameDR. SEAN C GILBEYCredential: MD
Location Address5920 W WILLIAM CANNON DR, BLDG 1 STE 150Austin, TX 78749-1902
Mailing Address5920 W William Cannon Dr, Bldg 1 Ste 150Austin, TX 78749-1902 · (512) 441-9799 · Fax (512) 441-9814
Fax(512) 441-9814
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 1995
Enumeration DateJune 10, 2005
Last NPPES UpdateOctober 24, 2016
NPI 1184628828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
License Licensed in TX · K6589
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License K6589 (TX)
5920 W WILLIAM CANNON DR, Austin, TX 78749

Other Identifiers 3

Medicare UPING50808TX
Medicare ID-Type Unspecified8G6580TX · Medicare
Medicaid147946104TX

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Sean C Gilbey Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2860303344
PECOS Enrollment IDI20070613000495
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.

Areas of Expertise CMS Part B claims 7

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 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.
108 services92 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.
57 services42 patients
Test to measure rate of airflow 94375
This test, known as spirometry, measures how much air you can breathe in and out, and how quickly you can do so. It helps assess your lung function and can be used to diagnose or monitor conditions like asthma or COPD.
44 services42 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
42 services40 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
42 services40 patients
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.
35 services34 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78749 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
$131.95 typical visit price
range $57.88 – $174.00
Typical copayment $32.98 (range $14.47 – $43.50)
Most-billed visit code 99204
Established Patient
$101.65 typical visit price
range $18.88 – $142.23
Typical copayment $25.41 (range $4.72 – $35.55)
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.

80.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality89.18
Improvement Activities40
Cost41.68

Reported Quality Measures

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…
87%345 patients4/55-star benchmark: 100%
Chronic Obstructive Pulmonary Disease (COPD): Long-Acting Inhaled Bronchodilator Therapy
Percentage of patients aged 18 years and older with a diagnosis of COPD (FEV1/FVC < 70%) and who have an FEV1 less than 60% predicted and have symptoms who were prescribed an long-acting inhaled bronchodilator
85%103 patients4/55-star benchmark: 100%
Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
82%162 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%728 patients5/55-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.
49%348 patients2/55-star benchmark: 100%
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.
100%32 patients5/55-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.
2%201 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
64%338 patients3/55-star benchmark: 95%
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…
81%201 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…
26%201 patients2/55-star benchmark: 79%
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 26

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
9 suppliers24 claims24 services$31.87 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
4 suppliers21 claims42 services$1.39 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable A7005
DME-Other DME · category DE000N
7 suppliers17 claims17 services$9.40 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
8 suppliers36 claims36 services$71.92 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
9 suppliers41 claims101 services$26.42 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
6 suppliers22 claims22 services$47.07 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 7

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

Dentist
5920 W WILLIAM CANNON DR, BLDG 6 SUITE 200
AUSTIN, TX 78749
Internal Medicine
5920 W WILLIAM CANNON DR, BLDG 6 SUITE 150
AUSTIN, TX 78749
Internal Medicine (Critical Care Medicine)
5920 W WILLIAM CANNON DR, BLDG 1 STE 150
AUSTIN, TX 78749
Family Medicine
5920 W WILLIAM CANNON DR, BUILDING 6 STE 150
AUSTIN, TX 78749
Chiropractor
5920 W WILLIAM CANNON DR, BUILDING 7, SUITE 100
AUSTIN, TX 78749
Internal Medicine (Critical Care Medicine)
5920 W WILLIAM CANNON DR, BLDG 1 STE 150
AUSTIN, TX 78749
Chiropractor
5920 W WILLIAM CANNON DR, BUILDING 7, SUITE 100
AUSTIN, TX 78749

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 Sean Gilbey's NPI number?

The NPI number for Sean Gilbey is 1184628828. It was assigned to this individual provider in the NPPES registry on June 10, 2005.

Where is Sean Gilbey located?

Sean Gilbey practices at 5920 W William Cannon Dr Bldg 1 Ste 150, Austin, TX 78749. The listed phone number is (512) 441-9799.

What is Sean Gilbey's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Sean Gilbey enrolled in Medicare?

Yes. Sean Gilbey is registered in the Medicare PECOS enrollment system.

What insurance does Sean Gilbey accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 4 other insurers list Sean Gilbey 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.

When was this NPI record last updated?

The NPPES record for Sean Gilbey was last updated on October 24, 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.