Individual provider Active NPI

Margaret T Thibodeau

  • Physician Assistant
  • Ogdensburg, NY
National Provider Identifier
1114370046
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
214 King Street
Ogdensburg, NY 13669
Phone
(315) 393-3600
Fax
(315) 393-7250
NPI assigned
Jul 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NY Primary

Addresses

Primary practice location

214 King Street
Ogdensburg, NY 13669

Mailing address

214 King Street
Ogdensburg, NY 13669
Phone (315) 393-3600

Other identifiers 1

IdentifierTypeStateIssuer
04838148MedicaidNY

Other names 1

  • Margaret T Ecker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20170807001366 NY Practitioner - Physician Assistant 7012288202 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mecker@hiemail.healtheconnections.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1114370046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 KING STREET",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "13669",
            "telephone_number": "315-393-3600",
            "fax_number": "315-393-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 KING STREET",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "13669",
            "telephone_number": "315-393-3600",
            "fax_number": "315-393-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "MARGARET",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04838148",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARGARET",
            "last_name": "ECKER",
            "middle_name": "T",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ogdensburg, NY

Sources for this page

Verify at the official NPI Registry.