Kyle Harrison Thibodeau, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

R4150 Issued in TX

Practice address

110 S Paca St Ste 200
Baltimore, MD 21201-1668

Phone

(410) 328-8025

NPI assigned

Apr 10, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Texas Emergency Physicians PLLCGroup PAC ID 8527420306, 195 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236
• Medical City Plano Hospital, Plano, TX, CCN 450651

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Northeast Texas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Longview, TX
  • NPI 1114607611
  Medicare reassignment Care Compare group NPD
• Ray Hubbard Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Sunnyvale, TX
  • NPI 1629145362
  Medicare reassignment NPD
• Questcare Medical Services, PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1912059247
  NPD
• Ray Hubbard Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Sunnyvale, TX
  • NPI 1073905568
  NPD

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

• Christus Hopkins Health Alliance

  dba Christus Mother Frances - Sulphur Springs

  • General Acute Care Hospital
  • Sulphur Springs, TX
  • NPI 1033568621
  Care Compare affiliation
• Columbia Medical Center of Plano Subsidiary LP

  dba Medical City Plano

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1699726406
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1285053827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S PACA ST STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011668",
            "telephone_number": "410-328-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PACA ST STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011668",
            "telephone_number": "410-328-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "KYLE",
        "middle_name": "HARRISON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0065421",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R4150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindly Theroux, D.O.
• Thi of Maryland at Franklin Square LLC (Fayette Health & Rehabilitation Center)
• Thi of Maryland at Liberty Heights LLC (Liberty Heights Health and Rehabilitation Center)
• Thi of Maryland at Northwest LLC (Northwest Health and Rehabilitation Center)
• Adji Thiam
• Jeffrey Paul Thiboutot, M.D.
• Alexandria M B Thielmeyer, PHD
• David Thiemann, M.D.
• Kevin Antwan Thigpen Jr.
• Nathan Michael Thimas

• Emergency Medicine Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Emergency Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.