TRAVIS LANE THIBAULT – Family Nurse Practitioner, NPI 1861990566

Family Nurse Practitioner

TRAVIS LANE THIBAULT is a healthcare provider. based in De soto, Kansas. specializing in Family Nurse Practitioner. They hold a License No. 2018001755 (MO). The NPI Number for TRAVIS LANE THIBAULT is 1861990566

Main info

Male

Sole Proprietor

9 Years Of Experience

Accepts Medicare Assignment

Name

TRAVIS LANE THIBAULT

NPI

1861990566

Phone

(913) 260-9250

Address

8438 TIMBER RIDGE DR

Enumeration Date

28 January 2018

Last Update Date

27 July 2021

Doctor Profile

Medical School Name

OTHER

Secondary Phone

9135415000

Graduation Year

2017 (9 years ago)

PAC ID

8224391537

Group Practice PAC ID

0648423632

Professional Enrollment ID

I20180503001236

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience49

Completeness75

Years active:8State licenses:2Digital endpointsOther names

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Provider Addresses for TRAVIS LANE THIBAULT

8438, Timber Ridge Drive, De Soto, Johnson County, Kansas, 66018, United States
DE SOTO, KS 660187122
Phone: (913) 260-9250
Type: Mailing
KANSAS EMERGENCY PHYSICIANS LLC
9100 W 74TH ST
SHAWNEE MISSION, KS 66204
Phone: (913) 260-9250
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: 2018-05-03

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

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20180503001236	I	Nurse Practitioner	KS	TBD

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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
99284	Emergency department visit with moderate level of medical decision making	87	85	$0
99285	Emergency department visit with high level of medical decision making	85	85	$0
99283	Emergency department visit with low level of medical decision making	35	35	$0

View full utilization report →

Insurance plans in this area (ZIP 66018)

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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: 0648423632View full group profile