Christopher D Theobald, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

349696 Issued in NY

Practice address

2233 State Route 86
Saranac Lake, NY 12983-5644

Phone

(518) 891-4141

NPI assigned

Jun 13, 2022

Sex

Male

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 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

Specialty

Nurse Practitioner

Education

State University of Ny Upstate Medical University, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adirondack Medical CenterGroup PAC ID 9638081284, shared by 8 NPIs, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCR / HCR Home Care Chha (Plattsburgh) Home health agency, Plattsburgh, NY, CCN 337024
• Adirondack Medical Center - Saranac Lake Hospital, Saranac Lake, NY, CCN 330079
• Canton-Potsdam Hospital Hospital, Potsdam, NY, CCN 330197

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Adirondack Medical Center

  • General Practice Physician
  • Saranac Lake, NY
  • NPI 1245446533

  Family

  Medicare reassignment NPD
• Adirondack Medical Center

  • Hospitalist Physician
  • Saranac Lake, NY
  • NPI 1487183174
  Medicare reassignment NPD
• Adirondack Medical Center

  • Surgery Physician
  • Saranac Lake, NY
  • NPI 1871359000
  NPD

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

• Adirondack Medical Center

  • General Acute Care Hospital
  • Saranac Lake, NY
  • NPI 1699709576
  Care Compare affiliation
• Adirondack Medical Center

  • General Acute Care Hospital
  • Saranac Lake, NY
  • NPI 1851601108
  Care Compare affiliation
• Canton-Potsdam Hospital

  • General Acute Care Hospital
  • Potsdam, NY
  • NPI 1568548782
  Care Compare affiliation
• L Woerner Inc

  • Home Health Agency
  • Plattsburgh, NY
  • NPI 1013354539
  Care Compare affiliation
• L Woerner Inc

  • Home Health Agency
  • Plattsburgh, NY
  • NPI 1215203740
  Care Compare affiliation
• L Woerner Inc

  • Home Health Agency
  • Plattsburgh, NY
  • NPI 1588938864
  Care Compare affiliation
• L Woerner Inc

  • Home Health Agency
  • Oneonta, NY
  • NPI 1649575549
  Care Compare affiliation

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1174253231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 STATE ROUTE 86",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 STATE ROUTE 86",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835644",
            "telephone_number": "518-891-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "CHRISTOPHER",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "349696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Stoddard
• Daniel Joseph Sullivan, LMT CERTIFIED IN ZB
• Mallory Supley
• Surgical Eye Care PLLC
• Christine Syx, LPN
• Lisa M Thomashow-Keegan
• Carolyn Rae Tidd, PA-C
• Jessica Marie Tietge
• Jennifer Tissot Van Patot, LCSW
• Anthony F Tramontano, M.D.

• Family Nurse Practitioner in Saranac Lake, NY
• Providers in Saranac Lake, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.