DR. ADLY THEBAUD (MD) – Psychiatry Physician, NPI 1629049770

DR. ADLY THEBAUD (MD) is a healthcare provider. based in Orange city, Florida. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. ME60436 (FL). The NPI Number for DR. ADLY THEBAUD (MD) is 1629049770

Main info

Male
Sole Proprietor
48 Years Of Experience
Accepts Medicare Assignment
Name
DR. ADLY THEBAUD (MD)
NPI
1629049770
Phone
(386) 775-0736
Address
2725 REBECCA LN STE 107
Enumeration Date
27 January 2006
Last Update Date
6 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3867750736
Graduation Year
1978 (48 years ago)
PAC ID
5597715920
Group Practice PAC ID
0143270579
Professional Enrollment ID
I20110406000825
Address ID
FL327638350OR2725XLNXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

1,954 PSYCHIATRY in FL

Provider Addresses for DR. ADLY THEBAUD (MD)

  • 2725 REBECCA LN STE 107

    ORANGE CITY, FL 327638350

    Phone: (386) 775-0736

    Fax: (386) 775-0738

    Type: Mailing

  • 1403, Medical Plaza Drive, Sanford, Seminole County, Florida, 32771, United States

    SUITE 202

    SANFORD, FL 327711000

    Phone: (407) 322-3096

    Fax: (407) 321-5655

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $2,103.

Total Amount is formed as General ($1,803) + Research ($300) + Ownership ($0) = $2,103.

Last reported payment date: 2024-07-03 • Largest payer in this snapshot: Neurocrine BioSciences, Inc. ($1,779).

Total Amount

$2,103

General + Research + Ownership

Payments

16

Total payment records

General Amount

$1,803

General payments

Research Amount

$300

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-03

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2011-04-06

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
I20110406000825IPsychiatryFLTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes22352$0
View full utilization report →

Insurance plans in this area (ZIP 32763)

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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: 0143270579View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Psychiatry, Family PracticeFL

Reviews

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Frequently asked questions

How do I look up DR. ADLY THEBAUD (MD) by NPI?
Use NPI 1629049770 when you need to reference DR. ADLY THEBAUD (MD) in forms, claims, or directories.
Is DR. ADLY THEBAUD (MD)'s NPI currently valid?
The extract we use shows DR. ADLY THEBAUD (MD) as active.
What kind of provider is DR. ADLY THEBAUD (MD)?
The page reflects Psychiatry Physician for DR. ADLY THEBAUD (MD). Clinical services aligned with this taxonomy classification.
Does DR. ADLY THEBAUD (MD) practice in Florida?
You will see Orange City, Florida on file for DR. ADLY THEBAUD (MD) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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