Matthew L Thibdeau, RPA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA-3205 Issued in CO

Practice address

300 Exempla Cir
Suite 360
Lafayette, CO 80026-3397

Phone

(303) 689-6560

Fax

(303) 689-6550

NPI assigned

Sep 12, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

JS Weill Medical College, Cornell University, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Medical Center LLC Hospital, Lafayette, CO, CCN 060116

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Denver, CO
  • NPI 1083021083
  Medicare reassignment Care Compare group NPD (past)
• Intermountain Medical Group Denver, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1083598874
  NPD
• Intermountain Medical Group Denver, LLC

  • Cardiovascular Disease Physician
  • Northglenn, CO
  • NPI 1932713153
  NPD

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

• Good Samaritan Medical Center, LLC

  • General Acute Care Hospital
  • Lafayette, CO
  • NPI 1407845035
  Care Compare affiliation

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1235324237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 EXEMPLA CIR",
            "address_2": "SUITE 360",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263397",
            "telephone_number": "303-689-6560",
            "fax_number": "303-689-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 EXEMPLA CIR",
            "address_2": "SUITE 360",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263397",
            "telephone_number": "303-689-6560",
            "fax_number": "303-689-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBDEAU",
        "first_name": "MATTHEW",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA-3205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97708585",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Labyrinth Institute, PLLC
• The Roost Training Center, LLC
• The Sequel Is Better LLC
• The Well Healing Center Inc.
• Todd A Theobald, M.D.
• Lawrence T Thillman, MA, MDIV
• Thejasvi Thiruvoipati, MD
• Brian J Thom, M.D.
• Chairel Thomas, RDH
• Janie A Thomas

• Surgical Physician Assistant in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Surgical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.