SAMUEL J THIBODEAUX CRNA
NPI 1578544516
Nurse Anesthetist, Certified Registered in Ukiah, CA
About Samuel J Thibodeaux Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL J THIBODEAUX CRNA (NPI 1578544516) is an individual nurse anesthetist, certified registered in Ukiah, California, licensed in California (NA3796) and active in the NPI registry since November 2005. He is a graduate of Other (2005).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 6
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Samuel J Thibodeaux Crna 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.
Medicare Billing Reassignments
2Medicare enrollment records show Samuel Thibodeaux reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Ukiah, CA 95482
- Reassigned Medicare billing, California enrollment
- 22 clinicians in this Medicare group
Willits, CA 95490
- Reassigned Medicare billing, California enrollment
- 134 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 6
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95482 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
UKIAH, CA 95482
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 Samuel Thibodeaux's NPI number?
The NPI number for Samuel Thibodeaux is 1578544516. It was assigned to this individual provider in the NPPES registry on November 8, 2005.
Where is Samuel Thibodeaux located?
Samuel Thibodeaux practices at 271 Observatory Ave, Ukiah, CA 95482. The listed phone number is (707) 462-0681.
What is Samuel Thibodeaux's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Samuel Thibodeaux enrolled in Medicare?
Yes. Samuel Thibodeaux is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Samuel Thibodeaux's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Thibodeaux reassigns Medicare benefits to 2 organizations: Anesthesia Management Services Of California Inc (Ukiah, CA) and Willits Hospital Inc. (Willits, CA). Each 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 Samuel Thibodeaux's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Samuel Thibodeaux was last updated on March 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Samuel J Thibodeaux, CRNA · NPI 1578544516
Nurse Anesthetist, Certified Registered physician in Ukiah, California. Individual provider, active in the CMS NPPES registry since November 8, 2005.
## Identity
- **NPI:** 1578544516 (Entity type: Individual)
- **Enumerated:** November 8, 2005
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** NA3796 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 271 OBSERVATORY AVE, Ukiah, CA 95482-5757
- **Phone:** (707) 462-0681
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Anesthesia Management Services Of California Inc (NPI 1003458704, Ukiah, CA); Willits Hospital Inc. (NPI 1356339543, Willits, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** March 22, 2013
- **Other identifiers:** Medicare PIN I15464 (IA); Other 39651 (IA); Medicare PIN P00257672 (IA); and 3 more
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Source: [NPI Profile](https://npiprofile.com/npi/1578544516) · Data from the CMS NPPES public registry.