FREDERICK THOMAS GIBSON
NPI 1629604483
Dermatology - Procedural Dermatology in Jamaica Plain, MA

Q: What is Frederick Gibson's NPI number?

The NPI number for Frederick Gibson is 1629604483. It was assigned to this individual provider in the NPPES registry on March 12, 2020.

Q: What is Frederick Gibson's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Q: When was this NPI record last updated?

The NPPES record for Frederick Gibson was last updated on November 17, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 12, 2020PECOS EnrolledAccepts Medicare Assignment

1153 CENTRE ST, JAMAICA PLAIN, MA 02130(617) 983-7000 Get Directions Write a Review

NPPES record last updated: November 17, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 17, 2025, Jul 7, 2021, Mar 12, 2020 (3 updates tracked since 2020).

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About Frederick Thomas Gibson NPPES

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

FREDERICK THOMAS GIBSON (NPI 1629604483) is an individual procedural dermatology provider in Jamaica Plain, Massachusetts, licensed in Massachusetts (1023149) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, maintains 4 additional practice locations, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2021).

NPPES Registry Identity

NPI1629604483

Entity TypeIndividualMale

Primary Taxonomy207NS0135X

Provider Legal NameFREDERICK THOMAS GIBSON

Location Address1153 CENTRE STJamaica Plain, MA 02130-3446

Mailing Address60 Charlesgate W Apt 3aBoston, MA 02215-2103

Phone(617) 983-7000

Sole ProprietorNo

Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2021

Enumeration DateMarch 12, 2020

Last NPPES UpdateNovember 17, 20253 updates tracked since enumeration

NPPES CertifiedNovember 17, 2025

✔ NPI 1629604483 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207NS0135X

License✔ Licensed in MA · 1023149

Definition

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

Also ListedInternal MedicineTaxonomy 207R00000X · License 289211 (MA)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1153 CENTRE ST, Jamaica Plain, MA 02130

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Secondary Practice Locations 4

Location 11740 W Taylor StChicago, IL 60612-7232 · Phone (866) 600-2273

Location 21 Boston Medical Center PlaceBoston, MA 02118 · Phone (617) 638-8000

Location 375 Francis StBoston, MA 02115-6110 · Phone (617) 732-5500

Location 42014 Washington StNewton, MA 02462-1607 · Phone (617) 243-6000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Frederick Thomas Gibson 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 ID1951779206

PECOS Enrollment IDI20250613002579

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02130 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

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

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.

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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.

MRS. MARY RAY MAZAKA LICSW

Social Worker (Clinical)

1153 CENTRE ST, 2ND FLOOR
BOSTON, MA 02130

Suffolk County (617) 983-7233

MRS. ELAINE ANN CHARBONNIER NP

Nurse Practitioner (Adult Health)

1153 CENTRE ST, FAULKNER HOSPITAL , DEPT OF PREADMISSION TESTING
BOSTON, MA 02130

Suffolk County (617) 933-4600

HYEJUNG KIM RPH

Pharmacist

1153 CENTRE ST
BOSTON, MA 02130

Suffolk County (851) 404-5397

FAINA NAKHLIS MD

Surgery (Surgical Oncology)

1153 CENTRE ST, FAULKNER BREAST CENTRE
BOSTON, MA 02130

Suffolk County (617) 983-7777

CATHERINE COQUINCO LLAMAS PA

Physician Assistant

1153 CENTRE ST
JAMAICA PLAIN, MA 02130

Suffolk County (617) 983-7132

KRISTIN MARIE STELTER LICSW, MFA

Social Worker (Clinical)

1153 CENTRE ST
BOSTON, MA 02130

Suffolk County (617) 983-4470

DOLORES MARIE SULA PA-C

Physician Assistant

1153 CENTRE ST
BOSTON, MA 02130

Suffolk County (617) 983-7000

DR. STACI R EISENBERG MD

Internal Medicine

1153 CENTRE ST
JAMAICA PLAIN, MA 02130

Suffolk County (617) 983-7025

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 Frederick Gibson's NPI number?

The NPI number for Frederick Gibson is 1629604483. It was assigned to this individual provider in the NPPES registry on March 12, 2020.

Where is Frederick Gibson located?

Frederick Gibson practices at 1153 Centre St, Jamaica Plain, MA 02130. The listed phone number is (617) 983-7000.

What is Frederick Gibson's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Is Frederick Gibson enrolled in Medicare?

Yes. Frederick 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 Frederick Gibson accept?

Health plans from Anthem Blue Cross and Blue Shield list Frederick 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.

When was this NPI record last updated?

The NPPES record for Frederick Gibson was last updated on November 17, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.