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DR. R CHASE THEBAULT M.D.
NPI 1699920082
Family Medicine in Detroit, MI

Active since November 26, 2008PECOS EnrolledAccepts Medicare Assignment
5555 CONNER ST STE 2818, DETROIT, MI 48213(313) 264-6490(313) 464-5012 Get Directions Write a Review

NPPES record last updated: July 27, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 27, 2026, May 18, 2022 (2 updates tracked since 2022).

About Dr. R Chase Thebault M.d. NPPES

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

DR. R CHASE THEBAULT M.D. (NPI 1699920082) is an individual family medicine provider in Detroit, Michigan, licensed in Michigan (4301104510) and active in the NPI registry since November 2008. He is enrolled in Medicare PECOS and is a graduate of Texas Tech University Health Science Center School Of Medicine (2006).

NPPES Registry Identity

NPI1699920082
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. R CHASE THEBAULTCredential: M.D.
Location Address5555 CONNER ST STE 2818Detroit, MI 48213-3448
Mailing Address5555 Conner St Ste 2818Detroit, MI 48213-3448 · (313) 264-6490 · Fax (313) 464-5012
Phone(313) 264-6490
Fax(313) 464-5012
Sole ProprietorNo
Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 2006
Enumeration DateNovember 26, 2008
Last NPPES UpdateJuly 27, 20262 updates tracked since enumeration
NPPES CertifiedJuly 27, 2026
✔ NPI 1699920082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 4301104510
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.
5555 CONNER ST STE 2818, Detroit, MI 48213
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

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

Dr. R Chase Thebault M.d. 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 ID8527114784
PECOS Enrollment IDI20141218001086
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.

Medicare Billing Reassignment

Medicare enrollment records show R Chase Thebault reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Covenant Community Care, Inc.
7.9 mi
Federally Qualified Health Center (FQHC)
5716 MICHIGAN AVE
Detroit, MI 48210
  • Reassigned Medicare billing, Michigan enrollment
  • 23 clinicians in this Medicare group
NPI 1720134943 (313) 554-1095

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48213 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

Other Providers at the Same Location NPPES 3

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

DR. RENEE SUSKO M.D.
Family Medicine
5555 CONNER ST STE 2818
DETROIT, MI 48213
Wayne County (313) 264-6490
ASCENSION MICHIGAN EMPLOYER SOLUTIONS LLC
General Acute Care Hospital
5555 CONNER ST STE 2818
DETROIT, MI 48213
Wayne County (248) 680-8121
NOLIA FOUNTAIN LLOYD LLP
Psychologist
5555 CONNER ST STE 2818
DETROIT, MI 48213
Wayne County (313) 264-6490

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 R Chase Thebault's NPI number?

The NPI number for R Chase Thebault is 1699920082. It was assigned to this individual provider in the NPPES registry on November 26, 2008.

Where is R Chase Thebault located?

R Chase Thebault practices at 5555 Conner St Ste 2818, Detroit, MI 48213. The listed phone number is (313) 264-6490.

What is R Chase Thebault's specialty?

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

Is R Chase Thebault enrolled in Medicare?

Yes. R Chase Thebault 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 organization bills Medicare for R Chase Thebault's services?

According to the CMS Revalidation Reassignment List (October 2026 release), R Chase Thebault reassigns Medicare benefits to Covenant Community Care, Inc. (Detroit, MI). The 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 R Chase Thebault's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does R Chase Thebault accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list R Chase Thebault as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for R Chase Thebault was last updated on July 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.