Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Erica Cordelle Thibeault, PA-C

Individual provider Surgical Physician Assistant · NPI 1124547625

Erica Cordelle Thibeault, PA-C is a Physician Assistant in Boston, Massachusetts. Qualified in 2017, 9 years ago. Practices with Pratt OB/GYN Associates, Inc, a 60-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
9
Licensed in
MA
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

300 Longwood Ave
Boston, MA 02115-5724
Phone: (617) 355-7648
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA6205 (MA)

Record details

NPI number1124547625
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 15, 2017
Last updated in NPPESSeptember 15, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Pratt Ob/Gyn Associates, Inc — 60 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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