Individual provider Active NPI

Emily M Tibbits, MD

  • Surgical Critical Care Physician
  • Travis Afb, CA
National Provider Identifier
1831523067
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
A134813 Issued in CA
Practice address
101 Bodin Cir
Travis Afb, CA 94535-1809
Phone
(707) 423-3000
NPI assigned
Aug 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 21420 NV
Surgery Physician 208600000X A134813 CA
Surgical Critical Care Physician 2086S0102X 21420 NV
Trauma Surgery Physician 2086S0127X 21420 NV
Trauma Surgery Physician 2086S0127X A134813 CA
Surgical Critical Care Physician 2086S0102X A134813 CA Primary

Addresses

Primary practice location

101 Bodin Cir
Travis Afb, CA 94535-1809

Mailing address

101 Bodin Cir
Travis Afb, CA 94535-1809
Phone (707) 423-3000

Other practice location 1

2335 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211130002022 NV Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 1052733896 Reassigns benefits to 1 organization
I20240531002593 CA Practitioner - General Surgery 1052733896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2221 Stockton Blvd
Sacramento, CA 95817-1418
Phone (916) 734-2680

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

4868 X St
Sacramento, CA 95817-2205

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134813CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Oct 27, 2021 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Unlv Medicine Current Accepting new patients
Unlv Medicine CurrentSince Oct 27, 2021 Accepting new patients
Regents of the Univ of Ca Surgery Past Accepting new patients
Dignity Health Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Lubbock County Hospital District Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Desert Springs Hospital Past Accepting new patients

Locations

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

3016 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 780-2315

1707 W Charleston Blvd
Ste 160
Las Vegas, NV 89102
Phone (702) 671-2201

Organizations & group practices 11

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.

Hospital & facility affiliations 1

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": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1831523067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2335 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172201",
            "country_code": "US",
            "telephone_number": "916-734-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIBBITS",
        "first_name": "EMILY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "21420",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A134813",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NV",
            "license": "21420",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NV",
            "license": "21420",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "A134813",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "A134813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

Verify at the official NPI Registry.