Active NPI
Mitchell Thomae, MD, MPH
- Family Medicine Physician
- Cheyenne, WY
National Provider Identifier
1700635489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- TL9257
- Practice address
- 821 E 18TH St
Cheyenne, WY 82001-4775 - Phone
- (307) 777-7911
- NPI assigned
- May 15, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | SG | WY | |
| Family Medicine Physician | 207Q00000X | TL9257 | WY | Primary |
Addresses
Primary practice location
821 E 18TH St
Cheyenne, WY 82001-4775
Mailing address
821 E 18TH St
Cheyenne, WY 82001-4775
Phone (307) 777-7911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250911000970 | WY | Order and Referring Only - Family Practice | 0648773119 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 244-T2 | WY | MD | Family Medicine Physician |
| SG | WY | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Wyoming | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- mitchell.thomae.1@30244.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Cheyenne, WY
- NPI 1770681439
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782432000000",
"number": "1700635489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "821 E 18TH ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820014775",
"telephone_number": "307-777-7911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "821 E 18TH ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820014775",
"telephone_number": "307-777-7911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAE",
"first_name": "MITCHELL",
"name_prefix": "Dr.",
"credential": "MD, MPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-15",
"last_updated": "2026-06-26",
"certification_date": "2026-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "WY",
"license": "SG",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WY",
"license": "TL9257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.