Dwight Thibodeaux, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

300 Issued in NM

Practice address

1409 Luisa St
Suite D
Santa Fe, NM 87505-7002

Phone

(505) 984-8989

Fax

(505) 984-8892

NPI assigned

Aug 18, 2006

Last updated

Feb 28, 2008By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Accent on Vision, Santa Fe LLCGroup PAC ID 3476534686, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

35.84 of 100Reported as individual

Quality

71.68

Improvement activities

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Accent on Vision, Santa Fe LLC

  • Optometrist
  • Santa Fe, NM
  • NPI 1912061086
  Medicare reassignment Care Compare group NPD Authorized official
• Visionwest, Inc.

  dba Dwight Thibodeaux

  • Optometrist
  • Espanola, NM
  • NPI 1598029308
  Authorized official Same address or phone

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1962516039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 LUISA ST",
            "address_2": "SUITE D",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057002",
            "telephone_number": "505-984-8989",
            "fax_number": "505-984-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 LUISA ST",
            "address_2": "SUITE D",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057002",
            "telephone_number": "505-984-8989",
            "fax_number": "505-984-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "DWIGHT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH PLAN",
            "identifier": "201009924",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "850448729T",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE HEALTH PLAN",
            "identifier": "850448729",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "850448729",
            "identifier": "UNITED HEALTH CARE",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Theis
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• Anthony Thieman-Somora
• Thomas McCaffrey PSYD LLC
• Thomas Spencer
• Bailey Jean Thomas
• Charla Elliott Thomas, LISW

• Optometrist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Optometrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; 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.