Nicholas R Thiessen, MD

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

48625 Issued in AZ

Practice address

485 S Dobson Rd Ste 201
Chandler, AZ 85224

Phone

(480) 728-4700

Fax

(480) 728-4747

NPI assigned

Feb 10, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Iowa, RJ & L Carver College of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chandler Regional Medical CenterGroup PAC ID 5395729784, 52 clinicians

Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036
• Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sjhmc Physician Services

  dba St. Joseph's Faculty Physicians

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1326098005
  Medicare reassignment Care Compare group NPD
• Chandler Regional Medical Center

  dba CRMC Trauma Services

  • Emergency Care Clinic/Center
  • Chandler, AZ
  • NPI 1871910968
  Medicare reassignment Care Compare group
• St Josephs Pathology

  dba Pathology Associates LTD

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1265407738
  NPD
• St. Joseph's Hospital and Medical Center

  dba SJHMC Trauma Services

  • Emergency Care Clinic/Center
  • Phoenix, AZ
  • NPI 1255382412
  NPD
• Dignity Community Care

  dba Chandler Regional Medical Center

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1700910189
  NPD (past)

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

• Dignity Community Care

  dba Chandler Regional Medical Center

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1700910189
  Care Compare affiliation
• Dignity Health

  dba Mercy Gilbert Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1992735088
  Care Compare affiliation

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1053550301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 S DOBSON RD STE 201",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85224",
            "telephone_number": "480-728-4700",
            "fax_number": "480-728-4747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1955 W Frye Rd",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852246282",
            "country_code": "US",
            "telephone_number": "480-728-4700",
            "fax_number": "480-728-4747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIESSEN",
        "first_name": "NICHOLAS",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-10",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "AZ",
            "license": "48625",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "R70173",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Critical Care Physician in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Surgical Critical Care Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.