NPIMap

Individual provider Active NPI

Lases Pearl Thibodeau, APRN

  • Family Nurse Practitioner
  • Lebanon, NH
National Provider Identifier
1447004841
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
078246-23 Issued in NH
Practice address
10 Alice Peck Day Dr # 03766290
Lebanon, NH 03766-2900
Phone
(603) 448-3121
NPI assigned
Apr 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 078246-23 NH Primary

Addresses

Primary practice location

10 Alice Peck Day Dr # 03766290
Lebanon, NH 03766-2900

Mailing address

20 Wolf Rd Apt C56
Lebanon, NH 03766-1916

Other practice location 1

20 Wolf Rd Apt C56
Lebanon, NH 03766-1916
Phone (603) 359-6609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241113002498 NH Practitioner - Nurse Practitioner 5890229868 Reassigns benefits to 2 organizations
I20260608002074 VT Practitioner - Nurse Practitioner 5890229868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alice Peck Day Memorial HospitalGroup PAC ID 6103737531, 132 clinicians
Brattleboro Memorial HospitalGroup PAC ID 9335112929, 70 clinicians

Practice addresses (Care Compare)

10 Alice Peck Day Dr
Lebanon, NH 03766-2900
Phone (603) 448-3121

21 Belmont Ave
Suite 1
Brattleboro, VT 05301-6762
Phone (802) 251-8455

Hospital & facility affiliations

  • Alice Peck Day Memorial Hospital Hospital, Lebanon, NH, CCN 301305
  • Brattleboro Memorial Hospital Hospital, Brattleboro, VT, CCN 470011
  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003
  • Mt Ascutney Hospital Hospital, Windsor, VT, CCN 471302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Peck Day Memorial Hospital CurrentSince Nov 6, 2024 Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Nov 6, 2024 Accepting new patients
Alice Peck Day Memorial Hospital Current Accepting new patients

Locations

10 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-7440

5 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-3996

Interoperability endpoints

  • FHIR API: https://edhwebportal.hitchcock.org/FHIRProxy/api/FHIR/R4/

Organizations & group practices 4

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1447004841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WOLF RD APT C56",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ALICE PECK DAY DR # 03766290",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037662900",
            "telephone_number": "603-448-3121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Wolf Rd Apt C56",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037661916",
            "country_code": "US",
            "telephone_number": "603-359-6609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "LASES",
        "middle_name": "PEARL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "078246-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.