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TERESA J TIBBETTS M D LLC
NPI 1053594275
Family Medicine in Lake Havasu City, AZ

Active since December 11, 2007
2082 MESQUITE AVE, SUITE A106, LAKE HAVASU CITY, AZ 86403(928) 680-4233(928) 680-6522 Get Directions Write a Review

NPPES record last updated: August 5, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Teresa J Tibbetts M D Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TERESA J TIBBETTS M D LLC (NPI 1053594275) is a healthcare organization registered as a family medicine in Lake Havasu City, Arizona and active in the NPI registry since December 2007. The organization lists Teresa J Tibbetts, Owner, as its authorized official.

NPPES Registry Identity

NPI1053594275
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameTERESA J TIBBETTS M D LLC
Location Address2082 MESQUITE AVE, SUITE A106Lake Havasu City, AZ 86403-6710
Mailing AddressPo Box 2325Lake Havasu City, AZ 86405-2325 · (928) 680-4233 · Fax (928) 680-6522
Phone(928) 680-4233
Fax(928) 680-6522
Organization SubpartNo
Authorized OfficialTeresa J TibbettsOwner · (928) 680-4233
Enumeration DateDecember 11, 2007
Last NPPES UpdateAugust 5, 2008
✔ NPI 1053594275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AZ · 27163
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2082 MESQUITE AVE, Lake Havasu City, AZ 86403
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Other Identifiers 6

Medicare PINZ102475
Medicare UPINH10595
OtherAZ0769200Bcbs Az
Medicaid474429AZ
Other2Z2286Health Net
OtherDD0854Railroad Medicare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Teresa J Tibbetts M D Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateArizonaEnrollment IDO20050421000943Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Teresa J Tibbetts M D LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Teresa Tibbetts, MD
Family Practice
NPI 1750486445
2082 MESQUITE AVE SUITE 106
Lake Havasu City, AZ 86403
(928) 680-4233
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Teresa J Tibbetts M D LLC's NPI number?

The NPI number for Teresa J Tibbetts M D LLC is 1053594275. It was assigned to this organization in the NPPES registry on December 11, 2007.

Where is Teresa J Tibbetts M D LLC located?

Teresa J Tibbetts M D LLC is located at 2082 Mesquite Ave Suite A106, Lake Havasu City, AZ 86403. The listed phone number is (928) 680-4233.

What is Teresa J Tibbetts M D LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Teresa J Tibbetts M D LLC enrolled in Medicare?

Yes. Teresa J Tibbetts M D LLC is registered in the Medicare PECOS enrollment system.

When is Teresa J Tibbetts M D LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arizona, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Teresa J Tibbetts M D LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Teresa J Tibbetts M D LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Teresa J Tibbetts M D LLC was last updated on August 5, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.