Michael D Thibert, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12103 Issued in CA

Practice address

475 Bruce St
Yreka, CA 96097-3474

Phone

(530) 842-1267

Fax

(530) 842-9121

NPI assigned

Jul 3, 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Siskiyou Hospital IncGroup PAC ID 1254223134, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairchild Medical Center Hospital, Yreka, CA, CCN 051316

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Siskiyou Hospital, Inc.

  dba Fairchild Medical Center

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1093892275
  Medicare reassignment Care Compare group NPD
• Siskiyou Hospital, Inc.

  dba Fairchild Medical Center

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1952701369
  NPD

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

• Siskiyou Hospital, Inc.

  dba Fairchild Medical Center

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1093892275
  Care Compare affiliation
• Siskiyou Hospital, Inc.

  dba Fairchild Medical Center

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1952701369
  Care Compare affiliation

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364860800000",
    "number": "1659301208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973474",
            "telephone_number": "530-842-1267",
            "fax_number": "530-842-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973474",
            "telephone_number": "530-842-1267",
            "fax_number": "530-842-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBERT",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00165970",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA12103",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katrina Anne Taylor, ASW/CADCIII
• Natasha Taylor
• Sabra Taylor, LPCC
• Jonathon Scott Temple, PHARM.D
• David S Terry
• Lisa Thomas-Axler
• Shirley Marie Thomas
• William K Thompson, MFTI
• Thrifty Payless Inc (Rite Aid Pharmacy 06104)
• Vicente Tlatilpa

• Physician Assistant in Yreka, CA
• Providers in Yreka, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.
• 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.