KEN GIBSON
NPI 1942278387
Family Medicine in Trafford, PA

Active since March 10, 2006PECOS EnrolledAccepts Medicare Assignment
78.53/100
CMS Quality Rating
833 STATE ROUTE 130, LEVEL GREEN SHOPPES, TRAFFORD, PA 15085(412) 856-7332 Get Directions Write a Review

NPPES record last updated: April 6, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 6, 2021, Aug 27, 2020 (2 updates tracked since 2020).

About Ken Gibson NPPES

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

KEN GIBSON (NPI 1942278387) is an individual family medicine provider in Trafford, Pennsylvania, licensed in Pennsylvania (MD039674E) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Magee Womens Hospital Of Upmc Health System, and is a graduate of Jefferson Medical College Of Thomas Jefferson University (1986).

NPPES Registry Identity

NPI1942278387
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameKEN GIBSON
Location Address833 STATE ROUTE 130, LEVEL GREEN SHOPPESTrafford, PA 15085-9700
Mailing Address833 State Route 130, Level Green ShoppesTrafford, PA 15085-9700
Sole ProprietorNo
Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 1986
Enumeration DateMarch 10, 2006
Last NPPES UpdateApril 6, 20212 updates tracked since enumeration
NPPES CertifiedAugust 27, 2020
NPI 1942278387 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in PA · MD039674E
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.
833 STATE ROUTE 130, Trafford, PA 15085

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

Ken 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 ID547398976
PECOS Enrollment IDI20100505001028
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 15

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.
442 services219 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
290 services174 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.
136 services136 patients
Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes 99347
An established patient home visit is a service where a healthcare professional visits your home for a 15-minute check-up. It's designed for patients who have previously seen the professional. The visit may include basic health assessments and discussions about your ongoing care.
108 services44 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.
65 services49 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
58 services18 patients

Hospital Affiliations CMS Care Compare 5

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

Magee Womens Hospital Of Upmc Health System

Acute Care Hospitals · Pittsburgh, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390114
Location300 Halket StreetPittsburgh, PA 15213 · Allegheny County
Emergency services Birthing friendly

Excela Health Westmoreland Regional Hospital

Acute Care Hospitals · Greensburg, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390145
Location532 West Pittsburgh StreetGreensburg, PA 15601 · Westmoreland County
Emergency services Birthing friendly

Upmc Presbyterian Shadyside

Acute Care Hospitals · Pittsburgh, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390164
Location200 Lothrop StreetPittsburgh, PA 15213 · Allegheny County
Emergency services

Excela Health Latrobe Hospital

Acute Care Hospitals · Latrobe, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390219
LocationOne Mellon WayLatrobe, PA 15650 · Westmoreland County
Emergency services

Upmc East

Acute Care Hospitals · Monroeville, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390328
Location2775 Mosside BoulevardMonroeville, PA 15146 · Allegheny County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15085 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

78.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.61
Promoting Interoperability100
Improvement Activities40
Cost53.82

Referred Medical Equipment & Supplies CMS DME claims 7

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
12 suppliers34 claims89 services$5.89 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers20 claims23 services$0.93 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
6 suppliers13 claims70 services$1.78 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
3 suppliers16 claims16 services$60.90 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier15 claims15 services$31.78 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 suppliers17 claims17 services$174.95 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

Family Medicine
833 STATE ROUTE 130, WORK
TRAFFORD, PA 15085
Specialist
833 STATE ROUTE 130
TRAFFORD, PA 15085

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 Ken Gibson's NPI number?

The NPI number for Ken Gibson is 1942278387. It was assigned to this individual provider in the NPPES registry on March 10, 2006.

Where is Ken Gibson located?

Ken Gibson practices at 833 State Route 130 Level Green Shoppes, Trafford, PA 15085. The listed phone number is (412) 856-7332.

What is Ken Gibson's specialty?

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

Is Ken Gibson enrolled in Medicare?

Yes. Ken 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.

Is Ken Gibson affiliated with any hospitals?

According to CMS data, Ken Gibson is affiliated with Magee Womens Hospital Of Upmc Health System, Excela Health Westmoreland Regional Hospital, Upmc Presbyterian Shadyside, Excela Health Latrobe Hospital and Upmc East.

When was this NPI record last updated?

The NPPES record for Ken Gibson was last updated on April 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.