Chandler N Thibodaux, P.A

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

01790 Issued in TX

Practice address

1307 8TH Ave Ste 505
Fort Worth, TX 76104-4143

Phone

(817) 927-2332

NPI assigned

Feb 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Chandler N Thibodaux Professional name

Medicare fee-for-service enrollment

Enrolled in TX

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

Physician Assistant

Education

University of Texas Medical Branch at Galveston, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Epiphany Dermatology PAGroup PAC ID 3971827791, 106 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.97 of 100Reported as group

Quality

76.91

Promoting interoperability

91

Improvement activities

40

Cost

77.16

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chandler.thibodaux@epiphanyderm.emadirect.md

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.

• Epiphany Dermatology PA

  • Dermatology Physician
  • Waco, TX
  • NPI 1043615263
  Medicare reassignment Care Compare group
• R Todd Plott MD PA

  • Dermatology Physician
  • Fort Worth, TX
  • NPI 1134426794
  NPD

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1205974045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 EAGLE DR",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760213219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 8TH AVE STE 505",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044143",
            "telephone_number": "817-927-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODAUX",
        "first_name": "CHANDLER",
        "middle_name": "N",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "01790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANDLER",
            "last_name": "THIBODAUX",
            "middle_name": "N",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mary Theuer, LPC
• Shaederrica Theus
• Thi of Texas at Fort Worth, LLC
• Thi of Texas at Forth Worth LLC
• Tran Thi, PA
• Verne Anthony Thibodeaux Jr., PHARM.D
• Holly Lynne Thiebaud, RN
• Avery Thies
• Thin Ryno, PLLC
• Third Eye After Hours, PLLC

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.