NPIMap

Individual provider Active NPI

Kathleen S. Thibault, D.O.

  • Family Medicine Physician
  • Milo, ME
National Provider Identifier
1689616260
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1613 Issued in ME
Practice address
135 Park St
Milo, ME 04463-1729
Phone
(207) 943-7752
Fax
(207) 943-1002
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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 1613 ME Primary

Addresses

Primary practice location

135 Park St
Milo, ME 04463-1729

Mailing address

135 Park St
Milo, ME 04463-1729
Phone (207) 943-7752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20051115000326 ME Practitioner - Family Practice 7315966777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Katahdin Valley Health CenterGroup PAC ID 4880659903, 66 clinicians

Practice addresses (Care Compare)

50 Summer St
Millinocket, ME 04462-1400
Phone (207) 528-2285

Hospital & facility affiliations

  • Northern Light Mayo Hospital Hospital, Dover Foxcroft, ME, CCN 201309
  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
  • St Joseph Hospital Hospital, Bangor, ME, CCN 200001

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1613MEMDFamily Medicine Physician
1631MEMDAddiction Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Katahdin Valley Health Center CurrentSince Jul 11, 2022 Accepting new patients
Katahdin Valley Health Center CurrentSince Jul 11, 2022 Accepting new patients
Katahdin Valley Health Center Current Accepting new patients

Locations

33 Walker St
Ashland, ME 04732
Phone (207) 435-6341

180 Main Rd
Brownville, ME 04414
Phone (207) 965-8700

188 Summer St
Dover Foxcroft, ME 04426
Phone (207) 523-3700

59 Bangor St
Houlton, ME 04730
Phone (207) 532-7161

50 Summer St
Millinocket, ME 04462
Phone (207) 723-6565

529 S Patten Rd
Patten, ME 04765

30 Houlton St
Patten, ME 04765
Phone (866) 366-5842

Interoperability endpoints

  • Direct secure messaging: kathleen.thibault.1@7377.direct.athenahealth.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 and National Provider Directory roles.

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1689616260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 PARK ST",
            "city": "MILO",
            "state": "ME",
            "postal_code": "044631729",
            "telephone_number": "207-943-7752",
            "fax_number": "207-943-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PARK ST",
            "city": "MILO",
            "state": "ME",
            "postal_code": "044631729",
            "telephone_number": "207-943-7752",
            "fax_number": "207-943-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBAULT",
        "first_name": "KATHLEEN",
        "middle_name": "S.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milo, ME

Sources for this page

Verify at the official NPI Registry.