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KAREN E MCGIBBON MD
NPI 1689780579
Family Medicine in Lanham, MD

Active since August 22, 2006PECOS EnrolledAccepts Medicare Assignment
3028 BRIGHTSEAT ROAD, #104, LANHAM, MD 20706(301) 772-6905(301) 772-6908 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Karen E Mcgibbon Md NPPES

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

KAREN E MCGIBBON MD (NPI 1689780579) is an individual family medicine provider in Lanham, Maryland, licensed in Maryland (D0052176) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Tidalhealth Peninsula Regional, Inc, and is a graduate of Howard University College Of Medicine (1994).

NPPES Registry Identity

NPI1689780579
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKAREN E MCGIBBONCredential: MD
Location Address3028 BRIGHTSEAT ROAD, #104Lanham, MD 20706
Mailing Address9440 Pennsylvania Avenue, #160Upper Marlboro, MD 20772-3687 · (301) 599-0460 · Fax (301) 599-0463
Phone(301) 772-6905
Fax(301) 772-6908
Sole ProprietorNo
Medical School CMSHoward University College Of MedicineGraduated 1994
Enumeration DateAugust 22, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1689780579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MD · D0052176
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3028 BRIGHTSEAT ROAD, Lanham, MD 20706
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Other Identifiers 1

Medicare UPINH30337

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Karen E Mcgibbon 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 ID9436297702
PECOS Enrollment IDI20150605001107
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.

Medicare Billing Reassignment

Medicare enrollment records show Karen Mcgibbon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Beebe Physician Network, Inc.
92 mi
Internal Medicine
1515 SAVANNAH RD
Lewes, DE 19958
  • Reassigned Medicare billing, Delaware enrollment
  • 382 clinicians in this Medicare group
NPI 1730133992 (302) 313-2300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 16

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.
1,136 services675 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
556 services556 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
128 services128 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.
84 services75 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
57 services57 patients
Hepatitis b vaccine (hepb), cpg-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use 90739
The Hepatitis B vaccine for adults is an injection that protects against the Hepatitis B virus. It's usually given as a series of 3 doses over 6 months. This vaccine helps your body build immunity, reducing the risk of Hepatitis B infection and its complications.
33 services20 patients

Hospital Affiliations CMS Care Compare

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

Tidalhealth Peninsula Regional, Inc

Acute Care Hospitals · Salisbury, MD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210019
Location100 East Carroll AvenueSalisbury, MD 21801 · Wicomico County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20706 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
78%529 patients4/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
71%993 patients4/55-star benchmark: 85%
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
22%214 patients1/55-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.
98%8,372 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
60%874 patients3/55-star benchmark: 88%
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%546 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.
42%1,731 patients2/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
35%1,120 patients2/55-star benchmark: 88%
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…
95%1,731 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…
10%1,731 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
25%1,731 patients
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 6

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
13 suppliers54 claims135 services$4.95 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers28 claims32 services$0.72 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers14 claims14 services$55.36 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers20 claims20 services$15.42 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers20 claims20 services$81.91 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers16 claims16 services$192.17 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Karen Mcgibbon's NPI number?

The NPI number for Karen Mcgibbon is 1689780579. It was assigned to this individual provider in the NPPES registry on August 22, 2006.

Where is Karen Mcgibbon located?

Karen Mcgibbon practices at 3028 Brightseat Road #104, Lanham, MD 20706. The listed phone number is (301) 772-6905.

What is Karen Mcgibbon's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Karen Mcgibbon enrolled in Medicare?

Yes. Karen Mcgibbon 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.

Which organization bills Medicare for Karen Mcgibbon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Karen Mcgibbon reassigns Medicare benefits to Beebe Physician Network, Inc. (Lewes, DE). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Karen Mcgibbon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Karen Mcgibbon accept?

Health plans from AmeriHealth Caritas Next list Karen Mcgibbon 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 Karen Mcgibbon affiliated with any hospitals?

According to CMS data, Karen Mcgibbon is affiliated with Tidalhealth Peninsula Regional, Inc.

When was this NPI record last updated?

The NPPES record for Karen Mcgibbon was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.