NICHOLAS GIBSON MD
NPI 1629719612
Hospitalist in Green Bay, WI

Q: What is Nicholas Gibson's NPI number?

The NPI number for Nicholas Gibson is 1629719612. It was assigned to this individual provider in the NPPES registry on April 5, 2022.

Q: What is Nicholas Gibson's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Gibson was last updated on June 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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 April 05, 2022PECOS EnrolledAccepts Medicare Assignment

2845 GREENBRIER RD, GREEN BAY, WI 54311(920) 288-8000 Get Directions Write a Review

NPPES record last updated: June 16, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 10, 2025, Sep 3, 2025, Apr 5, 2022 (3 updates tracked since 2022).

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About Nicholas Gibson Md NPPES

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

NICHOLAS GIBSON MD (NPI 1629719612) is an individual hospitalist provider in Green Bay, Wisconsin, licensed in Wisconsin (83881-20) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS, is affiliated with Aurora Medical Ctr Manitowoc County, and is a graduate of Medical College Of Wisconsin (2021).

NPPES Registry Identity

NPI1629719612

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameNICHOLAS GIBSONCredential: MD

Location Address2845 GREENBRIER RDGreen Bay, WI 54311-6519

Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250

Phone(920) 288-8000

Sole ProprietorNo

Medical School CMSMedical College Of WisconsinGraduated 2021

Enumeration DateApril 5, 2022

Last NPPES UpdateJune 16, 20263 updates tracked since enumeration

NPPES CertifiedJune 16, 2026

✔ NPI 1629719612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in WI · 83881-20

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License 83881 (WI)

2845 GREENBRIER RD, Green Bay, WI 54311

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Other Identifiers 1

Medicaid100281911WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, CareSource (Common Ground Healthcare).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

Nicholas Gibson 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 ID4789122292

PECOS Enrollment IDI20250717003109

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.

Hospital Affiliations CMS Care Compare 3

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

Aurora Medical Ctr Manitowoc County

Acute Care Hospitals · Two Rivers, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number520034

Location5000 Memorial DriveTwo Rivers, WI 54241 · Manitowoc County

Emergency services Birthing friendly

Bay Area Medical Center

Acute Care Hospitals · Marinette, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520113

Location3003 University DrMarinette, WI 54143 · Marinette County

Emergency services Birthing friendly

Aurora Baycare Medical Ctr

Acute Care Hospitals · Green Bay, WI

5/5 CMS rating

OwnershipProprietary

CMS Certification Number520193

Location2845 Greenbrier RdGreen Bay, WI 54311 · Brown County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54311 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

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.

AMRITHA CHANDRAHASA KARKERA M.D.

Internal Medicine (Hematology & Oncology)