Active NPI
Michael J. Thibodeau, M.D.
- Internal Medicine Physician
- Dearborn, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 57585
- Practice address
- 5500 Auto Club Dr
Dearborn, MI 48126-2779 - Phone
- (313) 982-8214
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 57585 | MI | Primary |
Addresses
Primary practice location
5500 Auto Club Dr
Dearborn, MI 48126-2779
Mailing address
5500 Auto Club Dr
Dearborn, MI 48126-2779
Phone (313) 982-8214
Other practice location 1
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mthibod12941@direct.hfhs.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Wayne State University School of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1 Ford PL
Detroit, MI 48202-3450
Phone (313) 874-6677
2799 W Grand Blvd
Detroit, MI 48202-2608
5500 Auto Club Dr
Dearborn, MI 48126-2779
Phone (313) 425-4500
Hospital & facility affiliations
- Henry Ford Home Health Care
- Henry Ford Health Hospital
- Henry Ford Health West Bloomfield Hospital
- Wyandotte Hospital and Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57585 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Health System | Internal Medicine | Current | Accepting new patients |
| Henry Ford Health System | Current | Accepting new patients |
Locations
19401 Hubbard Dr
Dearborn, MI 48126
Phone (313) 982-8100
1 Ford Pl
#2E
Detroit, MI 48202
Phone (313) 874-4688
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
Interoperability endpoints
- mthibodeau12941@direct.hfhs.org
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
- Internal Medicine Physician
- Detroit, MI
- NPI 1891702833
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
- General Acute Care Hospital
- West Bloomfield, MI
- NPI 1407867559
-
- Home Health Agency
- Detroit, MI
- NPI 1932162096
-
- Ambulatory Surgical Clinic/Center
- Wyandotte, MI
- NPI 1093901035
Hospital
-
- General Acute Care Hospital
- Wyandotte, MI
- NPI 1992725352
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616544000000",
"number": "1992873434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5500 AUTO CLUB DR",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262779",
"telephone_number": "313-982-8214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 AUTO CLUB DR",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262779",
"telephone_number": "313-982-8214"
}
],
"practiceLocations": [
{
"address_1": "2799 W Grand Blvd",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482022608",
"country_code": "US",
"telephone_number": "313-916-2600",
"fax_number": "313-916-3235",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THIBODEAU",
"first_name": "MICHAEL",
"middle_name": "J.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2021-03-24",
"certification_date": "2021-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "57585",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mthibod12941@direct.hfhs.org",
"affiliation": "N",
"address_1": "5500 Auto Club Dr",
"city": "Dearborn",
"state": "MI",
"country_code": "US",
"postal_code": "481262779",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.