Linda Theriault, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

694 Issued in MA

Practice address

3300 Main St
2ND Floor Suite a
Springfield, MA 01199-1002

Phone

(413) 794-7246

Fax

(413) 794-0198

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baystate Medical Center Hospital, Springfield, MA, CCN 220077

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baystate Medical Practices, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Springfield, MA
  • NPI 1548205909
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baystate Medical Center Inc

  • General Acute Care Hospital
  • Springfield, MA
  • NPI 1487655064
  Care Compare affiliation
• Baystate Medical Center Inc

  • Clinical Medical Laboratory
  • Springfield, MA
  • NPI 1568488450

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1003825316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991000",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MAIN ST",
            "address_2": "2ND FLOOR SUITE A",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991002",
            "telephone_number": "413-794-7246",
            "fax_number": "413-794-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIAULT",
        "first_name": "LINDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanne Theodat
• Theodore M Ingis MD PC
• Therapeutic Feet Inc
• Therapeutic Touch Massage, Inc.
• Camille Theriaque, LCSW
• Carol Theroux, RN
• Cheryl Ann Theroux, OTR
• Dianne Theroux
• Michelle Nicole Theroux, LMHC
• Emily Rose Thibaud

• Medical Physician Assistant in Springfield, MA
• Providers in Springfield, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.