Individual provider Active NPI

Rebecca M Thiesse, AU.D.

  • Audiologist
  • Olivia, MN
National Provider Identifier
1619303682
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
9024 Issued in MN
Practice address
600 E Park Ave
Ste 2
Olivia, MN 56277
Phone
(320) 523-3435
Fax
(320) 323-4374
NPI assigned
Sep 22, 2013
Last updated
Apr 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 9024 MN Primary

Addresses

Primary practice location

600 E Park Ave
Ste 2
Olivia, MN 56277

Mailing address

600 E Park Ave
Ste 2
Olivia, MN 56277
Phone (320) 523-3435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140305001680 MN Practitioner - Qualified Audiologist 7416187752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Massachusetts Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 E Park Ave
Suite 2
Olivia, MN 56277-1370
Phone (320) 523-3435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
TC Audiology LLC Audiologist CurrentSince Jul 1, 2014 Accepting new patients
Audiology Concepts, LLC Audiologist Past Accepting new patients

Locations

600 E Park Ave
#2
Olivia, MN 56277
Phone (320) 523-3435

Interoperability endpoints

  • Direct secure messaging: rthiesse190474@direct.centracare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1379808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1619303682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E PARK AVE",
            "address_2": "STE 2",
            "city": "OLIVIA",
            "state": "MN",
            "postal_code": "56277",
            "telephone_number": "320-523-3435",
            "fax_number": "320-323-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E PARK AVE",
            "address_2": "STE 2",
            "city": "OLIVIA",
            "state": "MN",
            "postal_code": "56277",
            "telephone_number": "320-523-3435",
            "fax_number": "320-323-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIESSE",
        "first_name": "REBECCA",
        "middle_name": "M",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-22",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "9024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olivia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.