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

Individual provider Surgical Physician Assistant · NPI 1376579631

Mr. Justin Robert Thibeault, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2010, 16 years ago. Practices with Northwest Surgical Specialists PC, a 117-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
16
Licensed in
OR
In the registry since
2006
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

1515 NW 18th Ave 3rd Fl
Portland, OR 97209-2516
Phone: (503) 224-8399
Fax: (503) 224-5661
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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 PA153476 (OR)

Record details

NPI number1376579631
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 25, 2006
Last updated in NPPESJuly 6, 2016

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Northwest Surgical Specialists Pc — 117 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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