MRS. THERESA MARIE THIELE (PAC) – Physician Assistant, NPI 1922023639
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MRS. THERESA MARIE THIELE (PAC)
101 FLAMINGO DR STE A
APOLLO BEACH, FL 335722600
Phone: (813) 645-7502
Type: Location
18103, Hamden Park Way, Tampa, Hillsborough County, Florida, 33647, United States
TAMPA, FL 33647
Phone: (813) 907-6433
Fax: (813) 645-9648
Type: Mailing
201, Flamingo Drive, North Ruskin, Apollo Beach, Hillsborough County, Florida, 33572, United States
APOLLO BEACH, FL 33572
Phone: (813) 645-4687
Fax: (813) 645-9648
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $1,191.
Total Amount is formed as General ($1,191) + Research ($0) + Ownership ($0) = $1,191.
Last reported payment date: 2024-12-14 • Largest payer in this snapshot: ABBVIE INC. ($557).
Total Amount
$1,191
General + Research + Ownership
Payments
18
Total payment records
General Amount
$1,191
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $557 |
| REVANCE THERAPEUTICS, INC. | $267 |
| MERZ NORTH AMERICA, INC. | $250 |
| Galderma Laboratories, L.P. | $117 |
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: 2007-02-22
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 |
|---|---|---|---|---|
| I20070222000278 | I | Physician Assistant | FL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33572)
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