MICHAEL J GILBERT MD
NPI 1932596988
Ophthalmology - Retina Specialist in Bellevue, WA

Active since April 16, 2015PECOS 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: June 18, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 18, 2020, Jun 19, 2016 (2 updates tracked since 2016).

About Michael J Gilbert Md NPPES

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

MICHAEL J GILBERT MD (NPI 1932596988) is an individual retina specialist in Bellevue, Washington, licensed in Washington (61043684) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS and is a graduate of Creighton University School Of Medicine (2015).

NPPES Registry Identity

NPI1932596988
Entity TypeIndividualMale
Primary Taxonomy207WX0107X
Provider Legal NameMICHAEL J 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 ProprietorNo
Medical School CMSCreighton University School Of MedicineGraduated 2015
Enumeration DateApril 16, 2015
Last NPPES UpdateJune 18, 20202 updates tracked since enumeration
NPPES CertifiedJune 18, 2020
NPI 1932596988 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License Licensed in WA · 61043684
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License 61043684 (WA)
12301 NE 10TH PL STE 200, Bellevue, WA 98005

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

Michael J 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 ID42516171
PECOS Enrollment IDI20200608000769
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 17

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.

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.
479 services238 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.
286 services180 patients
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.
242 services234 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.
202 services130 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
175 services38 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).
125 services90 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

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
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 1932596988. It was assigned to this individual provider in the NPPES registry on April 16, 2015.

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, specializing in Retina Specialist, with taxonomy code 207WX0107X.

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 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 June 18, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.