Daniel Thomas Thibodeau, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

011000711 Issued in VA

Practice address

400 Sentara Cir Ste 320
Williamsburg, VA 23188-5716

Phone

(757) 345-4800

NPI assigned

Jul 13, 2006

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

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science, Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dthibodeau1156343@direct.bsmhealth.org

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.

• Bon Secours Medical Group Hampton Roads Specialty Care LLC

  • Cardiovascular Disease Physician
  • Richmond, VA
  • NPI 1629637475
  Medicare reassignment NPD
• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment NPD
• Clarity Mental Health and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Williamsburg, VA
  • NPI 1912885609
  NPD Authorized official
• Carrollwood Emergency Physicians PA

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1215988829
  NPD (past)
• Franklin, Favata & Hulls, MD'S, PA

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1841240439
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1396760930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SENTARA CIR STE 320",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885716",
            "telephone_number": "757-345-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SENTARA CIR STE 320",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885716",
            "telephone_number": "757-345-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5838 Habourview Blvd",
            "address_2": "Suite 270",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "23435",
            "country_code": "US",
            "telephone_number": "757-541-1050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "DANIEL",
        "middle_name": "THOMAS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "011000711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diahnn Michelle Thompkins
• John R Thompson III, MD

• Physician Assistant in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.