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Deactivated NPI 1962800847 Deactivated / Inactive NPI Male Practitioner

Dr. Andre G Theriault , PhD

Contractor • Honolulu, HI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Andre Theriault has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 09, 2014
NPI Deactivation Date April 28, 2017
Total Practice Duration ~3 Years of Practice (2014 – 2017)

Professional Overview & Biography Verified Profile Summary

Dr. Andre Theriault, PhD was a registered Contractor practicing in Honolulu, HI. Throughout an active medical career spanning 3 years, Dr. Theriault provided care at the practice location at 802 PUNAHOU ST APT 705 until profile deactivation on 2017-04-28.

Practice Location & Contact Primary Location

Practice Address

802 Punahou St Apt 705

Honolulu, HI 968263637

Telephone 8082953423

Specialty Benchmarks & Practice Insights

Comparative analytics for Contractor in Honolulu, HI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 25.0 Yrs
Regional Practice Density
18 Specialists

Practicing in Honolulu, HI (60 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

Contractor Primary Specialty

NUCC Taxonomy Code: 171W00000X

State License FL DI 46030

A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated April 28, 2017

Record deactivated on April 28, 2017

NPI Profile Active December 09, 2014

NPI status registered as active in NPPES database

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Updated Practice Location December 09, 2014

Registered at 802 PUNAHOU ST APT 705, HONOLULU, HI 968263637 (Tel: 8082953423)

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Updated Business Mailing Address December 09, 2014

Registered at 802 PUNAHOU ST APT 705, HONOLULU, HI 968263637 (Tel: 8082953423)

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Provider Name / Credentials Updated December 09, 2014

Recorded as ANDRE THERIAULT, PHD

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 09, 2014

Contractor (License #DI 46030 in FL)

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Initial NPI Registration & Enumeration December 09, 2014

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: 1962800847
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 09, 2014
Last Update: December 09, 2014
Deactivation Date: April 28, 2017

Mailing Address

802 Punahou St Apt 705

Honolulu, HI 968263637

Phone: 8082953423

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.