Individual provider Active NPI

Mitchell Thomae, MD, MPH

  • Family Medicine Physician
  • Cheyenne, WY
National Provider Identifier
1700635489
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TL9257 Issued in WY
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

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250911000970 WY Order and Referring Only - Family PracticePractitioner - Family Practice 0648773119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
244-T2WYMDFamily Medicine Physician
SGWYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wyoming Family Medicine PastSince May 19, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.