David Charles Gibson, DO is a medicare enrolled "Emergency Medicine" physician in Hiram, Georgia. He went to Philadelphia College Of Osteopathic Medicine and graduated in 2011 and has 15 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice The Bortolazzo Group, Llc and his current practice location is
2518 Jimmy Lee Smith Pkwy, Hiram, Georgia. You can reach out to his office (for appointments etc.) via phone at
(470) 644-7000.
David Charles Gibson is licensed to practice in Ohio (license number 34-010859) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1467741553.
Physician's Profile
| Full Name | David Charles Gibson |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Experience | 15 Years |
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| Location | 2518 Jimmy Lee Smith Pkwy, Hiram, Georgia |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- David Charles Gibson attended and graduated from Philadelphia College Of Osteopathic Medicine in 2011
NPI Data:
- NPI Number: 1467741553
- Provider Enumeration Date: 03/30/2011
- Last Update Date: 12/04/2025
Medicare PECOS Information:
- PECOS PAC ID: 0143454819
- Enrollment ID: I20141106001324
Medical Identifiers
Medical identifiers for David Charles Gibson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1467741553 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | 34-010859 (Ohio) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| The Bortolazzo Group, Llc | 3476554320 | 98 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. David Charles Gibson allows following entities to bill medicare on his behalf.
| Entity Name | The Bortolazzo Group, LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1801965082
PECOS PAC ID: 3476554320
Enrollment ID: O20070122000015 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. David Charles Gibson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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David Charles Gibson, DO
5665 New Northside Dr,
Atlanta, GA 30328-5831
Ph: (770) 874-5400 | David Charles Gibson, DO
2518 Jimmy Lee Smith Pkwy,
Hiram, GA 30141-2068
Ph: (470) 644-7000 |
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