NICHOLAS PETER THEBERGE (DDS) – Oral & Maxillofacial Surgery (D.M.D.), NPI 1346580974
Oral & Maxillofacial Surgery (D.M.D.)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for NICHOLAS PETER THEBERGE (DDS)
285 HIGH ST
GREENFIELD, MA 013012608
Phone: (413) 774-2961
Type: Mailing
44 WHITE BIRCH DR
CHESTERFIELD, NH 034433622
Phone: (603) 903-3058
Type: Mailing
368 Canal St
Brattleboro, VT 053016618
Phone: (802) 254-9418
Fax: (802) 254-9418
Type: Location
272 Main St
Keene, NH 034314122
Phone: (603) 357-3709
Fax: (603) 357-3709
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2024-11-08 • Largest payer in this snapshot: Straumann USA LLC ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Straumann USA LLC | $16 |
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: 2017-07-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20170712001796 | I | Oral Surgery | VT | TBD |
| I20170712002155 | I | Oral Surgery | MA | TBD |
| I20170712002861 | I | Oral Surgery | NH | 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.
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 |
|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 17 | 17 | $0 |
Insurance plans in this area (ZIP 01301)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Maxillofacial Surgery | MA | |
| - | MA | |
| Maxillofacial Surgery, Oral Surgery, Oral Surgery | MA | |
| Maxillofacial Surgery, Oral Surgery | MA | |
| Maxillofacial Surgery, Oral Surgery | MA |
Reviews
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