JACOB TROY GIBBY (MD) – Neuroradiology Physician, NPI 1083174056

JACOB TROY GIBBY (MD) is a healthcare provider. based in Visalia, California. specializing in INTERVENTIONAL RADIOLOGY, DIAGNOSTIC RADIOLOGY. They hold the professional credentials MD. They hold a License No. 13494110-1205 (UT). The NPI Number for JACOB TROY GIBBY (MD) is 1083174056

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
JACOB TROY GIBBY (MD)
NPI
1083174056
Phone
Not provided
Address
400 W MINERAL KING AVE
Enumeration Date
25 March 2019
Last Update Date
24 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3086301111
Graduation Year
2019 (7 years ago)
PAC ID
3870016843
Group Practice PAC ID
1759285885
Professional Enrollment ID
I20250331002369
Address ID
UT846645726MA487XX500X301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness85
Years active:7State licenses:1Digital endpointsOther names

845 INTERVENTIONAL RADIOLOGY in CA

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Provider Addresses for JACOB TROY GIBBY (MD)

  • Kaweah Delta Medical Center, 400, West Mineral King Avenue, Visalia, Tulare County, California, 93291, United States

    VISALIA, CA 932916237

    Phone:

    Type: Mailing

  • 3152 N UNIVERSITY AVE STE 100

    PROVO, UT 846044746

    Phone: (801) 229-2002

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250331002369IDiagnostic RadiologyUTTBD
I20250908000261IDiagnostic RadiologyNETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 93291)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759285885View full group profile
NameSpecialtyState
Interventional RadiologyCO
-NE
Diagnostic Radiology, Interventional RadiologyIL
Emergency MedicineOR
Emergency MedicinePA
-SD
Diagnostic Radiology, Interventional Radiology, Diagnostic RadiologyCO
-NE
Emergency MedicineUT
Diagnostic RadiologyNE

Reviews

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Frequently asked questions

Where can patients find JACOB TROY GIBBY (MD)'s NPI?
You can confirm JACOB TROY GIBBY (MD) with NPI 1083174056; it appears in the national provider directory.
Does this profile mean JACOB TROY GIBBY (MD) is currently active?
Yes — JACOB TROY GIBBY (MD) appears active in the national provider directory.
Does JACOB TROY GIBBY (MD) list a primary specialty?
If you are matching referrals, note Neuroradiology Physician for JACOB TROY GIBBY (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for JACOB TROY GIBBY (MD)?
The page summarizes Visalia, California for JACOB TROY GIBBY (MD); expand the address list for detail.
What if Visalia, California seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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