KELLI NOELLE ELLIS THIBEDEAU (NPI# 1346601911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346601911 |
| Entity Type | Individual |
| Full Name | KELLI NOELLE ELLIS THIBEDEAU |
| Credential | PA |
| Practice Address |
851 Main St Suite 11, Brigham and Women's Neurosurgery Weymouth MA 02190-1612 |
| Mailing Address |
51 Performance Drive Brigham Surgical Associates, Suite 300 Weymouth MA 02189 |
| Practice Telephone | 7813314923 |
| Practice Fax Number | 7813400231 |
| Mailing Telephone | 7816244943 |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2019-09-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
851 MAIN ST SUITE 11, BRIGHAM AND WOMEN'S NEUROSURGERY |
| City | WEYMOUTH |
| State | MA |
| Zip Code | 02190-1612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629064068 | Javed Hamid Hussain | Pediatrics | 851 Main St, Suite25, Weymouth, MA 02190-1612 | 2005-09-21 |
| 1699161794 | Weymouth Pediatrics PC | Clinic/Center | 851 Main St, Suite25, Weymouth, MA 02190-1612 | 2015-04-15 |
| 1427487453 | South Shore Wellness & Renewal Inc. | Counselor | 851 Main St, Suite 16, Weymouth, MA 02190-1612 | 2013-11-12 |
| 1972949279 | Weymouth Oral and Maxillofacial Surgery, PC | Clinic/Center | 851 Main St, Suite #20, Weymouth, MA 02190-1612 | 2013-05-14 |
| 1982992624 | Foster Health Systems Inc | Home Health | 851 Main St, Suite 10, Weymouth, MA 02190-1612 | 2011-07-15 |
| 1922253657 | Iraj Aghdasi, Md PC | Internal Medicine | 851 Main St, Suite 24, Weymouth, MA 02190-1612 | 2008-11-21 |
| 1912095308 | Natov Medical Associates, PC | Specialist | 851 Main St, Suite 10, Weymouth, MA 02190-1612 | 2006-10-11 |
| 1174629190 | Cynthia M Rooney | Pediatrics | 851 Main St, Suite #6, Weymouth, MA 02190-1612 | 2006-09-16 |
| 1730170150 | Felisa Y Siy | Pediatrics | 851 Main St, Unit 18, Weymouth, MA 02190-1612 | 2005-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538702261 | Maureen L. Colella | Dentist | 33 Union St., So. Weymouth, MA 02190 | 2019-10-25 |
| 1740767060 | Convenientmd LLC | Clinic/Center | 2 Pond Street, Weymouth, MA 02190 | 2018-07-20 |
| 1437654399 | Swati Malik | Dentist | 174 Stonehaven Dr, South Weymouth, MA 02190 | 2018-03-24 |
| 1720496995 | Iona Dental, P.C. | Dentist | 1650 Main St., South Weymouth, MA 02190 | 2014-07-31 |
| 1497094411 | Cecilia R Briggs | Registered Nurse | 541 Main St Ste 414, South Weymouth, MA 02190 | 2013-02-12 |
| 1548523657 | Khaldoun Haj Mahmoud | Internal Medicine | Coastal Medical Associates, 55 Fogg Road, Weymouth, MA 02190 | 2012-06-22 |
| 1881992170 | Megan Elizabeth Lee | Physician Assistant | 851 Main Street, Suite 6, South Shore Neurospine, South Weymouth, MA 02190 | 2011-03-10 |
| 1790082253 | Bonnie Marie Kimball | Counselor | 549 Columbian Street, Weymouth, MA 02190 | 2011-02-18 |
| 1689805731 | Jane Marie Boomer | Early Intervention Provider Agency | 574 Main Street, Weymouth, MA 02190 | 2009-08-06 |
| 1619101136 | Jordan D Paulson | Psychiatry & Neurology | 55 Fogg Rd # 105, Weymouth, MA 02190 | 2009-05-12 |
| Find all providers in zip 02190 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861010613 | Cynthia X Campos | Physician Assistant | 8 Richmond St, Weymouth, MA 02188-2519 | 2020-07-08 |
| 1497392096 | Emma Dunbar | Physician Assistant | 86 Mansfield St, Weymouth, MA 02190-3127 | 2019-12-03 |
| 1295394971 | Shannon Marie Mullaney | Physician Assistant | 64 Taft Rd, Weymouth, MA 02188-3641 | 2019-06-06 |
| 1417326604 | Ocean State Urgent Care | Physician Assistant | 119 Liberty Bell Cir, Weymouth, MA 02189 | 2015-09-18 |
| 1639320336 | Kathleen Connelly Sullivan | Physician Assistant | 2 Fogg Rd, Weymouth, MA 02190 | 2008-10-01 |
| 1316505449 | Emily Ann Logan | Physician Assistant | 987 Main St, Weymouth, MA 02190-1652 | 2019-06-04 |
| 1467925198 | Alexandra Mckelvey | Physician Assistant | 55 Fogg Rd, Weymouth, MA 02190-2432 | 2019-01-04 |
| 1669906012 | Kristy Jurczak | Physician Assistant | 55 Fogg Rd, Weymouth, MA 02190 | 2017-04-12 |
| 1093191686 | Kathryn Marie Warren | Physician Assistant | 55 Fogg Rd, Weymouth, MA 02190 | 2015-08-05 |
| 1811380223 | Daniel Edward Borezo | Physician Assistant | 55 Fogg Rd, Weymouth, MA 02190 | 2015-03-09 |
| Find all providers in WEYMOUTH | ||||
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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.