Ethan James Thibodeaux, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

BP10074397 Issued in TX

Practice address

301 University Blvd
Galveston, TX 77555-5302

Phone

(409) 772-1221

Fax

(409) 772-1224

NPI assigned

Jun 14, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Anesthesiology

Education

University of Texas Medical Branch at Galveston, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Utmb Faculty Group Practice

  • General Practice Physician
  • Galveston, TX
  • NPI 1942241146

  Anesthesiology

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Texas Medical Branch at Galveston

  • General Acute Care Hospital
  • Galveston, TX
  • NPI 1548226988
  Care Compare affiliation

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1902474232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550877",
            "telephone_number": "409-772-1221",
            "fax_number": "409-772-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-1221",
            "fax_number": "409-772-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "ETHAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "BP10074397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Gulf Coast Center
• The University of Texas Medical Branch
• The University of Texas Medical Branch
• Therapy Unlimited
• Nancy Theriault, FNP
• Christina Thiel-Hsi, M.D.
• Third Coast Aesthetics and Wellness
• Michele Ann Tholcken, CPNP
• Anju Suzanna Thomas, MD
• Carla Y Thomas, M.A. LPC

• Anesthesiology Physician in Galveston, TX
• Providers in Galveston, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.