Matthew Thibodeaux, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1859-793AT Issued in LA

Practice address

13322 Highway 90 Ste L
Boutte, LA 70039-3010

Phone

(985) 785-8484

Fax

(985) 785-8483

NPI assigned

Aug 1, 2017

Last updated

Oct 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 LA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyecare Providers, LLCGroup PAC ID 2567359318, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eyecare Providers, LLC

  dba Eyecare Associates

  • Ophthalmology Physician
  • Metairie, LA
  • NPI 1477628154
  Medicare reassignment Care Compare group
• Artis Beatty a Professional Optometry Corporation

  dba MyEyeDr.

  • Optometrist
  • Jefferson, LA
  • NPI 1912416355
  Medicare reassignment NPD
• Artis Beatty a Professional Optometry Corporation

  dba MyEyeDr.

  • Optometrist
  • Boutte, LA
  • NPI 1013426451
  NPD
• Artis Beatty a Professional Optometry Corporation

  dba MyEyeDr.

  • Optometrist
  • Slidell, LA
  • NPI 1780317917
  NPD
• Eyecare Associates, Inc.

  • Optometrist
  • Prattville, AL
  • NPI 1902902463
  NPD (past)

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1194249086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13322 HIGHWAY 90 STE L",
            "city": "BOUTTE",
            "state": "LA",
            "postal_code": "700393010",
            "telephone_number": "985-785-8484",
            "fax_number": "985-785-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "MATTHEW",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-01",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1859-793AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Arc of St. Charles, Inc.
• The Arc of St. Charles, Inc.
• The Arc of St. Charles, Inc.
• The Arc of St. Charles, Inc.
• The Arc of St. Charles, Inc.
• CHI Tran
• Janie Tran, O.D.
• True Med Transportation LLC
• Wal-Mart Louisiana, LLC (Vision Center 30-2913)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2913)

• Optometrist in Boutte, LA
• Providers in Boutte, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.