Michael Stanley Thibault, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1389 Issued in CT

Practice address

25 Tamarack Avenue
Advanced Derm Care, PC
Danbury, CT 06811

Phone

(203) 797-8990

Fax

(203) 748-7861

NPI assigned

May 19, 2006

Last updated

Jan 16, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connecticut Skinhealth LLPGroup PAC ID 9638309362, 40 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.3 of 100Reported as group

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.thibault@schweigerderm.emadirect.md

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.

• Connecticut Skinhealth LLP

  • Specialist
  • Shelton, CT
  • NPI 1649606385
  Medicare reassignment Care Compare group NPD
• Schweiger Dermatology PLLC

  • Dermatology Physician
  • New York, NY
  • NPI 1831438662

  CT

  Medicare reassignment
• Advanced Dermcare PC

  • Dermatology Physician
  • Danbury, CT
  • NPI 1023068087
  NPD
• Eric R. Wolf, M.D., P.C.

  • Dermatology Physician
  • Groton, CT
  • NPI 1447459672
  NPD (past)
• The Hospital of Central Connecticut at New Britain General and Bradley

  dba The Hospital of Central Connecticut

  • General Acute Care Hospital
  • New Britain, CT
  • NPI 1053477075
  NPD (past)
• Big Sky Medicine PC

  dba Urgent Care Evergreen

  • Family Medicine Physician
  • Evergreen, CO
  • NPI 1164473088
  NPD (past)
• Blue Creek Medicine PC

  dba Blue Creek Family Medicine

  • Family Medicine Physician
  • Evergreen, CO
  • NPI 1598701591
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1659324515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 TAMARACK AVENUE",
            "address_2": "ADVANCED DERM CARE, PC",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06811",
            "telephone_number": "203-797-8990",
            "fax_number": "203-748-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 TAMARACK AVENUE",
            "address_2": "ADVANCED DERM CARE, PC",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06811",
            "telephone_number": "203-797-8990",
            "fax_number": "203-748-7861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Business Park Dr Ste 204",
            "address_purpose": "LOCATION",
            "city": "Branford",
            "state": "CT",
            "postal_code": "064052988",
            "country_code": "US",
            "telephone_number": "203-208-4082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIBAULT",
        "first_name": "MICHAEL",
        "middle_name": "STANLEY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "PA 1933",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "1389",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "001389",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA1933",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Stop & Shop Supermarket Company LLC (Stop and Shop Pharmacy#644)
• Heather H Thebodo, RPH
• Louis Vincent Theodos, DMD
• Sadiya Thermidor, MD
• Nicole E Theus
• Prafulla Thippeswami, RD.
• Aiswarya Anna Thomas, M.D.
• Erica Thompson, RN
• Nallie Cherpheng Thor, MD
• Barbara Thorpe

• Physician Assistant in Danbury, CT
• Providers in Danbury, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; 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.