SHELLEY THIBEAULT (NP) – Nurse Practitioner, NPI 1861155855
Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
8,106 NURSE PRACTITIONER in MI
Provider Addresses for SHELLEY THIBEAULT (NP)
1234 NAPIER AVE
SAINT JOSEPH, MI 490852112
Phone: (269) 983-8601
Fax: (269) 985-4549
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $46.
Total Amount is formed as General ($46) + Research ($0) + Ownership ($0) = $46.
Last reported payment date: 2023-06-02 • Largest payer in this snapshot: Organogenesis Inc. ($46).
Total Amount
$46
General + Research + Ownership
Payments
2
Total payment records
General Amount
$46
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organogenesis Inc. | $46 |
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: 2021-12-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211206000594 | I | Nurse Practitioner | MI | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 76 | 34 | $0 |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 51 | 41 | $0 |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 44 | 21 | $0 |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 35 | 21 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 24 | 11 | $0 |
Insurance plans in this area (ZIP 49085)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AZ | |
| - | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Pediatric Medicine | MI | |
| Internal Medicine | MI | |
| - | MI | |
| Nurse Practitioner | MI | |
| Internal Medicine | MI |
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