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Active NPI 1497120760 Individual Practitioner Male Practitioner

Thaddeus Dwayne Mitcham , PHYSICIAN ASSISTANT

Physician Assistant • Andersen Afb, GU

Professional Overview & Biography Verified Profile Summary

Thaddeus Mitcham, PHYSICIAN ASSISTANT is a registered healthcare professional specializing in Physician Assistant in Andersen Afb, GU. Practice services are available at 36TH MEDICAL GROUP under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

36th Medical Group
Unit 14010 Bldg 26012

Andersen Afb, GU 965434003

Telephone 6713664549

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Andersen Afb, GU

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 11.0 Yrs
Regional Practice Density
2 Specialists

Practicing in Andersen Afb, GU (28 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-08-08
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Amanda Solven , PA-C

Physician Assistant

NPI 1073083002

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location August 14, 2024

Registered at 36TH MEDICAL GROUP, UNIT 14010 BLDG 26012, ANDERSEN AFB, GU 965434003 (Tel: 6713664549)

📍
Updated Business Mailing Address August 14, 2024

Registered at 36TH MEDICAL GROUP, UNIT 14010 BLDG 26012, ANDERSEN AFB, GU 965434003 (Tel: 6713664549)

📍
Updated Practice Location August 18, 2023

Registered at 354 MEDICAL GROUP, 2630 CENTRAL AVE, EIELSON AFB, AK 997022301 (Tel: 9073776127)

📍
Updated Business Mailing Address August 18, 2023

Registered at 354 MEDICAL GROUP, 2630 CENTRAL AVE, EIELSON AFB, AK 997022301 (Tel: 9073776127)

📍
Updated Practice Location April 19, 2018

Registered at 7050 AIR DEPOT BLVD, TINKER AFB, OK 731458716 (Tel: 4055826231)

📍
Updated Business Mailing Address April 19, 2018

Registered at 7050 AIR DEPOT BLVD, TINKER AFB, OK 731458716 (Tel: 4055826231)

NPI Profile Active December 11, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location December 11, 2015

Registered at 4700 LAS VEGAS BLVD N, NELLIS AFB, NV 891916600 (Tel: 7026532532)

📍
Updated Business Mailing Address December 11, 2015

Registered at 4700 LAS VEGAS BLVD N, NELLIS AFB, NV 891916600 (Tel: 7026532532)

👤
Provider Name / Credentials Updated December 11, 2015

Recorded as THADDEUS MITCHAM, PHYSICIAN ASSISTANT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 11, 2015

Physician Assistant

🟢
Initial NPI Registration & Enumeration December 11, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497120760
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 11, 2015
Last Update: August 14, 2024
Sole Proprietor: No

Mailing Address

36th Medical Group, Unit 14010 Bldg 26012

Andersen Afb, GU 965434003

Phone: 6713664549

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.