Mr Keith M Thibault, NP in Oakland, CA - Medicare Nurse Practitioner

Mr Keith M Thibault, NP is a medicare enrolled "Nurse Practitioner" in Oakland, California. His current practice location is 275 W Macarthur, Oakland, California. You can reach out to his office (for appointments etc.) via phone at (510) 752-1000.

Mr Keith M Thibault is licensed to practice in California (license number 5122) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1013078674.

Contact Information

	Mr Keith M Thibault, NP
	275 W Macarthur, Oakland, CA 94611-5641
	(510) 752-1000
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Keith M Thibault
Gender	Male
Speciality	Nurse Practitioner
Location	275 W Macarthur, Oakland, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1013078674
Provider Enumeration Date: 12/13/2006
Last Update Date: 11/14/2014

Medicare PECOS Information:

PECOS PAC ID: 8729039938
Enrollment ID: I20050204000533

Medical Identifiers

Medical identifiers for Mr Keith M Thibault such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013078674	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	5122 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Keith M Thibault allows following entities to bill medicare on his behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Keith M Thibault is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Keith M Thibault, NP 275 W Macarthur, Oakland, CA 94611-5641 Ph: (510) 752-1000	Mr Keith M Thibault, NP 275 W Macarthur, Oakland, CA 94611-5641 Ph: (510) 752-1000

Reviews and Comments

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Mr Keith M Thibault, NP - Medicare Nurse Practitioner in Oakland, CA