DR. MICHAEL L GILBERT MD
NPI 1386646065
Ophthalmology in Bellevue, WA

Active since August 12, 2005PECOS EnrolledAccepts Medicare Assignment
78.39/100
CMS Quality Rating
12301 NE 10TH PL STE 200, BELLEVUE, WA 98005(425) 450-2020(425) 688-0620 Get Directions Write a Review

NPPES record last updated: March 11, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Michael L Gilbert Md NPPES

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

DR. MICHAEL L GILBERT MD (NPI 1386646065) is an individual ophthalmology provider in Bellevue, Washington, licensed in Washington (MD00027511) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and is a graduate of Baylor College Of Medicine (1983).

NPPES Registry Identity

NPI1386646065
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. MICHAEL L GILBERTCredential: MD
Location Address12301 NE 10TH PL STE 200Bellevue, WA 98005-2487
Mailing Address12301 Ne 10th Pl Ste 200Bellevue, WA 98005-2487 · (425) 450-2020 · Fax (425) 688-0620
Fax(425) 688-0620
Sole ProprietorYes
Medical School CMSBaylor College Of MedicineGraduated 1983
Enumeration DateAugust 12, 2005
Last NPPES UpdateMarch 11, 2016
NPI 1386646065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in WA · MD00027511
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
12301 NE 10TH PL STE 200, Bellevue, WA 98005

Other Identifiers 2

Medicare PINGAB22158WA
Medicare UPINB65137WA

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 and accepts Medicare assignment

Dr. Michael L Gilbert 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.

PECOS PAC ID9931097755
PECOS Enrollment IDI20100219000128
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 18

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 complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
598 services565 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
365 services332 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.
328 services203 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
203 services131 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
181 services79 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
168 services159 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98005 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
$143.76 typical visit price
range $63.67 – $189.37
Typical copayment $35.94 (range $15.91 – $47.34)
Most-billed visit code 99204
Established Patient
$78.74 typical visit price
range $21.12 – $155.00
Typical copayment $19.68 (range $5.28 – $38.75)
Most-billed visit code 99213
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.

78.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost27.99

Reported Quality Measures

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
100%80 patients5/55-star benchmark: 100%
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.

Other Providers at the Same Location NPPES 5

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

Optometrist
12301 NE 10TH PL STE 200
BELLEVUE, WA 98005
Ophthalmology
12301 NE 10TH PL STE 200
BELLEVUE, WA 98005
Optometrist (Corneal and Contact Management)
12301 NE 10TH PL STE 200
BELLEVUE, WA 98005
Ophthalmology
12301 NE 10TH PL STE 200
BELLEVUE, WA 98005
Ophthalmology (Retina Specialist)
12301 NE 10TH PL STE 200
BELLEVUE, WA 98005

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 Michael Gilbert's NPI number?

The NPI number for Michael Gilbert is 1386646065. It was assigned to this individual provider in the NPPES registry on August 12, 2005.

Where is Michael Gilbert located?

Michael Gilbert practices at 12301 NE 10th Pl Ste 200, Bellevue, WA 98005. The listed phone number is (425) 450-2020.

What is Michael Gilbert's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Michael Gilbert enrolled in Medicare?

Yes. Michael 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 Michael Gilbert accept?

Health plans from PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Michael 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.

When was this NPI record last updated?

The NPPES record for Michael Gilbert was last updated on March 11, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.