Kelli N Thibedeau, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

851 Main St
Suite 11, Brigham and Women'S Neurosurgery
Weymouth, MA 02190-1612

Phone

(781) 331-4923

Fax

(781) 340-0231

NPI assigned

Mar 10, 2016

Sex

Female

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 MA

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

Tufts University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thibedeau.kelli.bwh@direct.partners.masshiway.net

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.

• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment Care Compare group
• Coastal Medical Associates

  • Anesthesiology Physician
  • Weymouth, MA
  • NPI 1932175684
  Medicare reassignment Care Compare group
• Brigham and Women'S Hospital

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1093885816
  NPD

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

• South Shore Hospital Inc.

  • General Acute Care Hospital
  • South Weymouth, MA
  • NPI 1134227606
  Care Compare affiliation

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1346601911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 PERFORMANCE DRIVE",
            "address_2": "BRIGHAM SURGICAL ASSOCIATES, SUITE 300",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "02189",
            "telephone_number": "781-624-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 MAIN ST",
            "address_2": "SUITE 11, BRIGHAM AND WOMEN'S NEUROSURGERY",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021901612",
            "telephone_number": "781-331-4923",
            "fax_number": "781-340-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBEDEAU",
        "first_name": "KELLI",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-10",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Landing Dentistry
• The South Shore Center for Plastic Reconstructive and Hand Surgery LLC
• Lindsay R. Thelin, OTR/L
• Kristen Fleurie Theodoris
• Holly Lynn Theriault
• Shirley Thompson-Parchment, LMHC
• Aubrey Thompson, FDN
• Julia Thompson
• Emma C Thomson, LICSW
• Riley Thorr, DPT

• Physician Assistant in Weymouth, MA
• Providers in Weymouth, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.