NPIMap

Individual provider Active NPI

Chelsea Thibodeau, D.O.

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1538693916
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
67491 Issued in MN
Practice address
2020 E 28TH St
Minneapolis, MN 55407-1394
Phone
(612) 333-0770
NPI assigned
Apr 12, 2017
Last updated
Aug 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 67491 MN Primary

Addresses

Primary practice location

2020 E 28TH St
Minneapolis, MN 55407-1394

Mailing address

2020 E 28TH St
Minneapolis, MN 55407-1394
Phone (612) 333-0770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200929001328 MN Practitioner - Family Practice 0749550507 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

2020 E 28TH St
Minneapolis, MN 55407-1394
Phone (612) 333-0770

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
67491MNMDFamily Medicine Physician
69929MNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Aug 31, 2020 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Aug 31, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Nov 21, 2020 Accepting new patients
University of Minnesota Physicians CurrentSince Aug 31, 2020 Accepting new patients
Planned Parenthood Minnesota, North Dakota, South Dakota CurrentSince Aug 12, 2021 Accepting new patients
Fairview Express Care CurrentSince Aug 31, 2020 Accepting new patients
Fairview Express Care CurrentSince Aug 31, 2020 Accepting new patients
University of Minnesota Physicians CurrentSince Aug 31, 2020 Accepting new patients
Fairview Clinics CurrentSince Nov 21, 2020 Accepting new patients
Fairview Health Services Past Accepting new patients
University of Wisconsin Medical Foundation, Inc Past Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

2020 E 28th St
Minneapolis, MN 55407
Phone (612) 333-0770

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0331

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

671 Vandalia St
Saint Paul, MN 55114
Phone (651) 696-5674

Interoperability endpoints

  • Direct secure messaging: cthibodeau505983@fairview.direct-ci.com

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 3

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": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1538693916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071394",
            "telephone_number": "612-333-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071394",
            "telephone_number": "612-333-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "CHELSEA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "67491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.