Patrice M Thibodeau, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DR.0054626 Issued in CO

Practice address

28000 Meadow Drive #210
Evergreen, CO 80439

Phone

(303) 679-8500

Fax

(303) 679-8505

NPI assigned

Oct 4, 2006

Last updated

Jan 15, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ME

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

Internal Medicine

Education

University of Chicago, Pritzker School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthreach Community Health CentersGroup PAC ID 5496726523, shared by 12 NPIs, 87 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthreach Community Health Centers

  dba Belgrade Regional Health Center

  • Federally Qualified Health Center (FQHC)
  • Belgrade, ME
  • NPI 1851364632
  Medicare reassignment NPD
• Healthreach Community Health Centers

  dba Lawrence High School Health Center

  • Federally Qualified Health Center (FQHC)
  • Fairfield, ME
  • NPI 1285302893
  NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1902992308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 MEADOW DR UNIT 210",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804392116",
            "telephone_number": "303-679-8500",
            "fax_number": "303-679-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28000 MEADOW DRIVE #210",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "80439",
            "telephone_number": "303-679-8500",
            "fax_number": "303-679-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "PATRICE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0054626",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "MD15542",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CO",
            "license": "DR.0054626",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER PTAN",
            "identifier": "C544638",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "378538YY4G",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tausel Consulting LLC
• Terry M. Levy,PH.D.,P.a.
• TFL Provider Network LLC (The Fitness Lab)
• The Center for Holistic Health at Crossroads Chiropractic
• The Winds of Change PLLC
• John Lewis Thomas Jr.
• Katherine A Thomas, BCBA
• Laura Thompson-Beato, LPCC
• Lisa Thompson
• Weslee David Thompson, DPT

• Internal Medicine Physician in Evergreen, CO
• Providers in Evergreen, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.