MAXINE A THERIOT MD
NPI 1194874628
Preventive Medicine - Undersea and Hyperbaric Medicine in Poplar Bluff, MO

Q: What is Maxine Theriot's NPI number?

The NPI number for Maxine Theriot is 1194874628. It was assigned to this individual provider in the NPPES registry on January 10, 2007. The provider is also known as Maxine A Dawes MD.

Q: What is Maxine Theriot's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Undersea and Hyperbaric Medicine, with taxonomy code 2083P0011X.

Q: When was this NPI record last updated?

The NPPES record for Maxine Theriot was last updated on July 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since January 10, 2007PECOS EnrolledAccepts Medicare Assignment

3098 OAK GROVE RD, POPLAR BLUFF, MO 63901(573) 686-8199(573) 686-8398 Get Directions Write a Review

NPPES record last updated: July 13, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 13, 2023, Mar 6, 2023, Jul 1, 2020 (3 updates tracked since 2020).

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About Maxine A Theriot Md NPPES

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

MAXINE A THERIOT MD (NPI 1194874628) is an individual undersea and hyperbaric medicine provider in Poplar Bluff, Missouri, licensed in Missouri (2022047286) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Central Dupage Hospital, and maintains a secondary practice location in Grapevine.

NPPES Registry Identity

NPI1194874628

Entity TypeIndividualFemale

Primary Taxonomy2083P0011X

Provider Legal NameMAXINE A THERIOTCredential: MD

Location Address3098 OAK GROVE RDPoplar Bluff, MO 63901-8938

Mailing Address709 W Rusk St Ste BRockwall, TX 75087-3600 · (972) 786-0140 · Fax (972) 786-0142

Phone(573) 686-8199

Fax(573) 686-8398

Sole ProprietorNo

Medical School CMSLoma Linda University School Of MedicineGraduated 1994

Enumeration DateJanuary 10, 2007

Last NPPES UpdateJuly 13, 20233 updates tracked since enumeration

NPPES CertifiedJuly 13, 2023

✔ NPI 1194874628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPreventive Medicine · Undersea and Hyperbaric MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2083P0011X

Licenses✔ Licensed in MO · 2022047286✔ Licensed in TX · J9578

Definition

A specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide poisoning, gas gangrene, non-healing wounds, tissue damage from radiation and burns and bone infections. This specialist also serves as consultant to other physicians in all aspects of hyperbaric chamber operations and assesses risks and applies appropriate standards to prevent disease and disability in divers and other persons working in altered atmospheric conditions.

Also ListedFamily MedicineTaxonomy 207Q00000X · License J9578 (TX)

3098 OAK GROVE RD, Poplar Bluff, MO 63901

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Other Names 1

Former Name (1)Maxine A Dawes Md

Secondary Practice Location 1

Location 11650 W College StGrapevine, TX 76051-3565 · Phone (972) 816-0459

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Maxine A Theriot Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648296525

PECOS Enrollment IDI20230322000964

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

591 services132 patients

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

564 services109 patients

Removal of skin and tissue, each additional 20.0 sq cm or less 11045

This procedure involves the removal of skin and tissue, typically due to disease, injury, or abnormal growth. Each session removes an area of 20.0 square cm or less. It's performed by a trained professional and may require multiple sessions for larger areas.

387 services29 patients

Removal of tissue from wound, 20.0 sq cm or less 97597

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

112 services52 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

77 services50 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

73 services57 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140242

Location25 North Winfield RoadWinfield, IL 60190 · Du Page County

Emergency services Birthing friendly

Poplar Bluff Regional Medical Center

Acute Care Hospitals · Poplar Bluff, MO

2/5 CMS rating

OwnershipProprietary

CMS Certification Number260119

Location3100 Oak Grove RoadPoplar Bluff, MO 63901 · Butler County

Emergency services Birthing friendly

Mercy Hospital Stoddard

Acute Care Hospitals · Dexter, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260160

Location1200 N One Mile RdDexter, MO 63841 · Stoddard County

Emergency services

Saint Francis Medical Center

Acute Care Hospitals · Cape Girardeau, MO

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260183

Location211 St Francis DrCape Girardeau, MO 63703 · Cape Girardeau County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$121.96 typical visit price

range $52.28 – $161.24

Typical copayment $30.49 (range $13.07 – $40.31)

Most-billed visit code 99204

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

99%2,071 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

96%263 patients4/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

99%212 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

75%371 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

42%335 patients2/55-star benchmark: 100%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

33%27 patients2/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

31%371 patients2/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

0%371 patients1/55-star benchmark: 79%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6216

DME-Medical/Surgical Supplies · category DA023N

1 supplier15 claims3,000 services$0.04 avg. paid by Medicare

Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing A6252

DME-Medical/Surgical Supplies · category DA023N

1 supplier13 claims270 services$2.93 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL J LIM MD

Internal Medicine (Cardiovascular Disease)