Jeffrey M Thibodeau, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3739 Issued in ME

Practice address

180 Waterman Dr
South Portland, ME 04106-3659

Phone

(207) 550-0660

NPI assigned

Aug 23, 2011

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 ME

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Saco Bay Orthopaedic and Sports Physical Therapy, Inc

  dba Saco Bay Orthopaedic Sports & Physical Therapy

  • Physical Therapist
  • Saco, ME
  • NPI 1346254315
  Medicare reassignment NPD
• Saco Bay Orthopaedic and Sports Physical Therapy, Inc.

  dba Saco Bay Orthopaedic Sports & Physical Therapy

  • Physical Therapy Clinic/Center
  • Westbrook, ME
  • NPI 1396312807
  NPD

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1629358502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 ROBIE ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381726",
            "telephone_number": "207-432-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WATERMAN DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063659",
            "telephone_number": "207-550-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-23",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT3739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Opportunity Alliance
• The Opportunity Alliance
• The Opportunity Alliance
• Peter Rene Then, DMD DR MED DENT
• Sonya L Theriault, LCSW
• Andrea Thomas, PA-C
• Grace Thomas, D.D.S.
• Lisa R Thomas, MD
• Robin G Thomas, MS, CCC-SLP
• Beth Thompson, MS, LATC

• Physical Therapist in South Portland, ME
• Providers in South Portland, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.