MR. JUSTIN ROBERT THIBEAULT PA-C NPI 1376579631

NPI Information

  • NPI: 1376579631
  • Provider Name: MR. JUSTIN ROBERT THIBEAULT, PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1515 NW 18TH AVE
    3RD FLOOR
    PORTLAND, OR
    ZIP 97209
  • Phone: (503) 224-8399

Map and Directions

Get Directions

NPI Details

MR. Justin Robert Thibeault, PA-C is a surgical physician assistant in Portland, OR with 15 years of experience. MR. Justin Robert Thibeault, PA-C NPI is 1376579631. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1515 NW 18TH AVE
3RD FLOOR
PORTLAND, OR
ZIP 97209-516
Phone: (503) 224-8399
Fax: (503) 224-5661

The NPI 1376579631 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose (HCPCS:J7324)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • X-ray of knee, 4 or more views (HCPCS:73564)
  • Injection, methylprednisolone acetate, 80 mg (HCPCS:J1040)
  • X-ray of knee, 3 views (HCPCS:73562)
  • Replacement of knee joint, both sides of knee (HCPCS:27447)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)

The enumeration date for this NPI number is 6/25/2006 and was last updated on 7/6/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgicalPA153476OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI