JACK MICHAEL GIBSON (M.D.) – Obstetrics & Gynecology Physician, NPI 1346235777

JACK MICHAEL GIBSON (M.D.) is a healthcare provider. based in Peoria, Illinois. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials M.D.. They hold a License No. 036064619 (IL). The NPI Number for JACK MICHAEL GIBSON (M.D.) is 1346235777

Main info

Male
45 Years Of Experience
Accepts Medicare Assignment
Name
JACK MICHAEL GIBSON (M.D.)
NPI
1346235777
Phone
(309) 696-2297
Address
530 NE GLEN OAK AVE
Enumeration Date
12 September 2005
Last Update Date
18 July 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3096816960
Graduation Year
1981 (45 years ago)
PAC ID
3476567199
Group Practice PAC ID
3072422716
Professional Enrollment ID
I20060203000156
Address ID
IL616033201PE507XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,923 OBSTETRICS/GYNECOLOGY in IL

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Provider Addresses for JACK MICHAEL GIBSON (M.D.)

  • OSF Saint Francis Medical Center, 530, Northeast Glen Oak Avenue, Roanoke-Randolph Street Historic District, Peoria, Peoria County, Illinois, 61637, United States

    PEORIA, IL 616370001

    Phone: (309) 696-2297

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2024-07-23 • Largest payer in this snapshot: Inspire Medical Systems, Inc. ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2006-02-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20060203000156IObstetrics/GynecologyILTBD

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 61637)

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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: 3072422716View full group profile
NameSpecialtyState
Internal MedicineIL
O B S T E T R I C S/ G Y N E C O L O G YIL
-IL
-IL
Gastroenterology, Internal MedicineWI
-IL
O P H T H A L M O L O G YNY
O T O L A R Y N G O L O G YCA
Certified Registered Nurse Anesthetist (Crna)IA
G A S T R O E N T E R O L O G YFL

Reviews

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Frequently asked questions

How do payers reference JACK MICHAEL GIBSON (M.D.)?
For JACK MICHAEL GIBSON (M.D.), use NPI 1346235777 as the unique 10-digit identifier.
Is JACK MICHAEL GIBSON (M.D.) still an active registrant?
JACK MICHAEL GIBSON (M.D.) carries an active NPI according to the public dataset.
How would a patient describe JACK MICHAEL GIBSON (M.D.)'s focus?
For JACK MICHAEL GIBSON (M.D.), the primary taxonomy reads as Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with JACK MICHAEL GIBSON (M.D.)?
Directory geography for JACK MICHAEL GIBSON (M.D.) centers on Peoria, Illinois.
Does JACK MICHAEL GIBSON (M.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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DEPT OF OB / GYN
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