DR. TODD A THEOBALD (M.D.) – Ophthalmology Physician, NPI 1720077993

DR. TODD A THEOBALD (M.D.) is a healthcare provider. based in Lafayette, Colorado. specializing in OPHTHALMOLOGY. They hold the professional credentials M.D.. They hold a License No. 2009032081 (MO). The NPI Number for DR. TODD A THEOBALD (M.D.) is 1720077993

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
DR. TODD A THEOBALD (M.D.)
NPI
1720077993
Phone
(303) 338-4545
Address
280 EXEMPLA CIR
Enumeration Date
19 October 2005
Last Update Date
21 June 2021

Doctor Profile

Medical School Name
ST. LOUIS COLLEGE OF PHYSICIANS AND SURGEONS
Secondary Phone
3033384545
Graduation Year
2001 (25 years ago)
PAC ID
0042355273
Group Practice PAC ID
1254238454
Professional Enrollment ID
I20161213000099
Address ID
CO800263370LA280XXCIRC301

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience86
Completeness85
Years active:20State licenses:4Other namesUpdated within 12 months

396 OPHTHALMOLOGY in CO

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Provider Addresses for DR. TODD A THEOBALD (M.D.)

  • KP Drop Off, 280, Exempla Circle, Lafayette, Boulder County, Colorado, 80026-2872, United States

    LAFAYETTE, CO 800263370

    Phone: (303) 338-4545

    Type: Mailing

  • 10350 E DAKOTA AVE

    DENVER, CO 802471314

    Phone: (303) 338-4545

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-12-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20161213000099IOphthalmologyCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80026)

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Provider's Procedures

DR. TODD A THEOBALD (M.D.) performs procedures in OPHTHALMOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPHTHALMOLOGYCO92012Eye and medical examination for diagnosis and treatment, established patient147120
OPHTHALMOLOGYCO92083Measurement of field of vision during daylight conditions8575
OPHTHALMOLOGYCO92134Diagnostic imaging of retina157106

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254238454View full group profile
NameSpecialtyState
Nurse PractitionerCO
-CO
Physical Therapist In Private PracticeCO
-CO
-CO
-CO
Cardiovascular Disease (Cardiology)CO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Family PracticeCO

Reviews

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Frequently asked questions

What is DR. TODD A THEOBALD (M.D.)'s NPI number?
DR. TODD A THEOBALD (M.D.)'s NPI is 1720077993 — the number used across U.S. healthcare to identify this provider.
Would DR. TODD A THEOBALD (M.D.) appear as active to a payer?
You can treat DR. TODD A THEOBALD (M.D.) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe DR. TODD A THEOBALD (M.D.)'s focus?
For DR. TODD A THEOBALD (M.D.), the primary taxonomy reads as Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. TODD A THEOBALD (M.D.)?
Travel planning: use Lafayette, Colorado as the reference point for DR. TODD A THEOBALD (M.D.), then confirm.
Can I trust this NPI listing for DR. TODD A THEOBALD (M.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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