MR. MATTHEW L THIBDEAU (NPI# 1235324237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235324237 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW L THIBDEAU |
| Credential | RPA-C |
| Practice Address |
300 Exempla Cir Suite 360 Lafayette CO 80026-3397 |
| Practice Telephone | 3036896560 |
| Practice Fax Number | 3036896550 |
| Mailing Telephone | 3036896560 |
| Mailing Fax Number | 3036896550 |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2011-09-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA-3205 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 97708585 | 05 |
| Street Address |
300 EXEMPLA CIR SUITE 360 |
| City | LAFAYETTE |
| State | CO |
| Zip Code | 80026-3397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063485936 | Ernest Edward Nitka | Psychiatry & Neurology | 300 Exempla Cir, Suite 230, Lafayette, CO 80026-3397 | 2006-02-09 |
| 1598379984 | Scl Health Medical Group - Denver, LLC | Internal Medicine | 300 Exempla Cir, Lafayette, CO 80026-3397 | 2020-09-02 |
| 1821538174 | Lauren Elizabeth Hammer | Nurse Practitioner | 300 Exempla Cir, Suite 470, Lafayette, CO 80026-3397 | 2017-03-06 |
| 1952858185 | Heather Dunham | Nurse Practitioner | 300 Exempla Cir, Suite 420, Lafayette, CO 80026-3397 | 2016-09-06 |
| 1972927382 | Froc, PC | Orthopaedic Surgery | 300 Exempla Cir, Suite 200, Lafayette, CO 80026 | 2014-02-06 |
| 1518300367 | Sarah Braden White | Emergency Medicine | 300 Exempla Cir, #204, Lafayette, CO 80026-3397 | 2013-04-11 |
| 1144517947 | Katrina Marie Pack | Psychiatry & Neurology | 300 Exempla Cir, Suite 230, Lafayette, CO 80026-3397 | 2011-06-30 |
| 1700184322 | Lafayette Pediatrics and Internal Medicine | Clinic/Center | 300 Exempla Cir, Suite 420, Lafayette, CO 80026-3397 | 2011-03-06 |
| 1003120502 | Erik Berger | Internal Medicine | 300 Exempla Cir, Suite 300, Lafayette, CO 80026-3397 | 2010-07-27 |
| 1154654804 | Banner Greeley Specialists | Clinic/Center | 300 Exempla Cir, Suite 200, Lafayette, CO 80026-3397 | 2009-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528671690 | Julia Michele Colton | Occupational Therapist | 110 S. Roosevelt Ave, Lafayette, CO 80026 | 2020-08-28 |
| 1265045900 | Amber M. Roter | Social Worker | 588 N Us-287 Co, Suite 200, Lafayette, CO 80026 | 2020-08-24 |
| 1669008314 | Dr. Sunda Friedman Tebockhorst Psychologicl Services, Ltd | Clinic/Center | 588 N Hwy 287, Suite 200, Lafayette, CO 80026 | 2020-03-13 |
| 1659918910 | Emily Nicole Pearson | Behavior Technician | 961 Sandstone Circle, Lafayette, CO 80026 | 2019-12-05 |
| 1790320612 | Gs Campus Asc, LLC | Clinic/Center | Lafayette Surgery Center, 340 Exempla Circle, Suite #400, Lafayette, CO 80026 | 2019-11-14 |
| 1639711864 | Martina Christina Holzach | Student in an Organized Health Care Education/Training Program | 1455 Dixon Ave, Suite #300, Lafayette, CO 80026 | 2019-10-09 |
| 1104474055 | 2nd Star Counseling | Clinic/Center | 260 S. Public Rd, Lafayette, CO 80026 | 2019-09-03 |
| 1912460015 | Premier Eye Surgery Center of Colorado, LLC | Clinic/Center | 1050 W. South Boulder Road, Lafayette, CO 80026 | 2019-04-08 |
| 1144704883 | Nikole J Randolph | Nutritionist | 2770 Dagny Way Suite 210, Lafayette, CO 80026 | 2018-09-19 |
| 1609388842 | Claro Scientific Laboratories Corp | Clinical Medical Laboratory | 1408 Horizon Ave Ste 101, Lafayette, CO 80026 | 2017-10-27 |
| Find all providers in zip 80026 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033737366 | Wound Solutions Inc | Physician Assistant | 130 Old Laramie Trl Ste 100, Lafayette, CO 80026-7014 | 2020-07-13 |
| 1558685495 | Douglas D Kesler | Physician Assistant | 1411 S Creasy Lane, Suite 120, Lafayette, IN 47905-7433 | 2010-03-22 |
| 1285895060 | Jennifer Menard Piker | Physician Assistant | 605 Silverstone Road, Suite 100, Lafayette, LA 70508 | 2008-06-24 |
| 1013019108 | Tabatha Alma Tomajko | Physician Assistant | 300 Exempla Circle, Suite 360, Bluestone Advanced Surgical Care, Lafayette, CO 80026 | 2006-09-01 |
| 1437134707 | Cal Anthony Domingue | Physician Assistant | 5000 Ambassador Caffery Pkwy Bldg 14a, Lafayette, LA 70508-6984 | 2005-12-09 |
| 1811997075 | James R. Redmond Sr. | Physician Assistant | 601 W Saint Mary Blvd, Ste 308, Lafayette, LA 70506-3568 | 2005-07-28 |
| 1326694076 | Nathan J Ambrose | Physician Assistant | 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA 70508-6984 | 2019-08-16 |
| 1720536618 | Richard Davis | Physician Assistant | 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA 70508-6984 | 2016-09-20 |
| 1205218914 | Amanda Murray | Physician Assistant | 3900 St Francis Way Ste 201, Lafayette, IN 47905-4923 | 2015-06-18 |
| 1245666254 | Emily Renee Thibodaux | Physician Assistant | 1103 Kaliste Saloom Rd, Suite 206, Lafayette, LA 70508-5783 | 2013-09-23 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.