Individual provider Active NPI

Christopher Thibeault

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1205487493
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1205487493 Issued in OK
Practice address
10326 S Oswego Ave
Tulsa, OK 74137
Phone
(918) 863-3789
NPI assigned
Sep 27, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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 1205487493 OK Primary

Addresses

Primary practice location

10326 S Oswego Ave
Tulsa, OK 74137

Mailing address

10326 S Oswego Ave
Tulsa, OK 74137
Phone (918) 863-3789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20200214002045 OK Practitioner - Physician Assistant 6305272188 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3331
Phone (918) 488-6000

Hospital & facility affiliations

  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
  • Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1205487493OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Oct 9, 2023 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

6151 S Yale Ave
Ste 1304
Tulsa, OK 74136
Phone (918) 494-5300

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

10505 E 91st St
Ste 208
Tulsa, OK 74133
Phone (918) 307-5470

6151 S Yale Ave
Ste 100A
Tulsa, OK 74136
Phone (918) 494-2100

Interoperability endpoints

  • Direct secure messaging: cthibeault118786@direct.saintfrancis.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1205487493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10326 S OSWEGO AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74137",
            "telephone_number": "918-863-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10326 S OSWEGO AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74137",
            "telephone_number": "918-863-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBEAULT",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-27",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1205487493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.