Samuel J Thibodeaux, CRNA | |
271 Observatory Ave, Ukiah, CA 95482-5757 | |
(707) 462-0681 | |
Not Available |
Full Name | Samuel J Thibodeaux |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 19 Years |
Location | 271 Observatory Ave, Ukiah, California |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578544516 | NPI | - | NPPES |
39651 | Other | IA | WELLMARK BCBS |
0469627 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | D105288 (Iowa) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | NA3796 (California) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Adventist Health Ukiah Valley | Ukiah, CA | Hospital |
Adventist Health Howard Memorial | Willits, CA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Anesthesia Management Services Of California Inc | 0840626040 | 8 |
Willits Hospital Inc | 7416940697 | 54 |
Entity Name | Willits Hospital Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356339543 PECOS PAC ID: 7416940697 Enrollment ID: O20040405000843 |
Entity Name | Anesthesia Management Services Of California Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003458704 PECOS PAC ID: 0840626040 Enrollment ID: O20200206002375 |
Mailing Address | Practice Location Address |
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Samuel J Thibodeaux, CRNA Po Box 34120, Reno, NV 89533-4120 Ph: (775) 747-5050 | Samuel J Thibodeaux, CRNA 271 Observatory Ave, Ukiah, CA 95482-5757 Ph: (707) 462-0681 |
Carmen Nicholas Dibenedetto, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 275 Hospital Dr, Ukiah, CA 95482 Phone: 707-463-7516 |