JORGE A GILBERT M.D.
NPI 1205831377
Internal Medicine - Gastroenterology in Sioux Falls, SD

Q: What is Jorge Gilbert's NPI number?

The NPI number for Jorge Gilbert is 1205831377. It was assigned to this individual provider in the NPPES registry on June 16, 2005.

Q: What is Jorge Gilbert's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Jorge Gilbert was last updated on April 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 June 16, 2005PECOS EnrolledAccepts Medicare Assignment

90.18/100

CMS Quality Rating

1205 S GRANGE AVE STE 104, SIOUX FALLS, SD 57105(605) 328-8500(605) 328-8501 Get Directions Write a Review

NPPES record last updated: April 18, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jorge A Gilbert M.d. NPPES

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

JORGE A GILBERT M.D. (NPI 1205831377) is an individual gastroenterology provider in Sioux Falls, South Dakota, licensed in South Dakota (4837) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Sanford Luverne Medical Center, and is a graduate of Other (1989).

NPPES Registry Identity

NPI1205831377

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameJORGE A GILBERTCredential: M.D.

Location Address1205 S GRANGE AVE STE 104Sioux Falls, SD 57105-0414

Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074 · (605) 328-6585 · Fax (605) 328-6512

Phone(605) 328-8500

Fax(605) 328-8501

Sole ProprietorNo

Medical School CMSOtherGraduated 1989

Enumeration DateJune 16, 2005

Last NPPES UpdateApril 18, 2013

✔ NPI 1205831377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in SD · 4837

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

1205 S GRANGE AVE STE 104, Sioux Falls, SD 57105

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Other Identifiers 3

Medicare PINS40346SD

Medicare UPINF67347

Medicaid6004182SD

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan, Security Health Plan.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

Jorge A Gilbert 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 ID547296741

PECOS Enrollment IDI20051212000269

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 11

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.

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

136 services136 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

118 services117 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

61 services61 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

57 services56 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.

56 services46 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

52 services49 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

39 services39 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

29 services29 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

17 services17 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.

16 services16 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

15 services15 patients

Hospital Affiliations CMS Care Compare 3

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

Sanford Luverne Medical Center

Critical Access Hospitals · Luverne, MN

OwnershipVoluntary non-profit - Private

CMS Certification Number241371

Location1600 N Kniss AvenueLuverne, MN 56156 · Rock County

Emergency services

Avera Mckennan Hospital & University Health Center

Acute Care Hospitals · Sioux Falls, SD

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number430016

Location1325 S Cliff AveSioux Falls, SD 57117 · Minnehaha County

Emergency services Birthing friendly

Sanford Usd Medical Center

Acute Care Hospitals · Sioux Falls, SD

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number430027

Location1305 W 18th St Post Office Box 5039Sioux Falls, SD 57117 · Minnehaha County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57105 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

$126.78 typical visit price

range $55.52 – $167.23

Typical copayment $31.69 (range $13.88 – $41.80)

Most-billed visit code 99204

Established Patient

$97.88 typical visit price

range $18.08 – $137.08

Typical copayment $24.47 (range $4.52 – $34.27)

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.

90.18/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

86.69

Improvement Activities

Cost

91.67

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Other Providers at the Same Location NPPES 2

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

DR. BRETT DANIEL BALOUN MD

Internal Medicine (Gastroenterology)

1205 S GRANGE AVE STE 104
SIOUX FALLS, SD 57105

Minnehaha County (605) 328-8500

ASHLEY OLIVER

Nurse Practitioner

1205 S GRANGE AVE STE 104
SIOUX FALLS, SD 57105

Minnehaha County (605) 328-8500

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 Jorge Gilbert's NPI number?

The NPI number for Jorge Gilbert is 1205831377. It was assigned to this individual provider in the NPPES registry on June 16, 2005.

Where is Jorge Gilbert located?

Jorge Gilbert practices at 1205 S Grange Ave Ste 104, Sioux Falls, SD 57105. The listed phone number is (605) 328-8500.

What is Jorge Gilbert's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Jorge Gilbert enrolled in Medicare?

Yes. Jorge Gilbert 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 Jorge Gilbert accept?

Health plans from Medica, Sanford Health Plan and Security Health Plan list Jorge Gilbert 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 Jorge Gilbert affiliated with any hospitals?

According to CMS data, Jorge Gilbert is affiliated with Sanford Luverne Medical Center, Avera Mckennan Hospital & University Health Center and Sanford Usd Medical Center.

When was this NPI record last updated?

The NPPES record for Jorge Gilbert was last updated on April 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.