Doctor profile · Federal record
Dr. Kelly Thibault, CRNP
Pediatric Nurse Practitioner (CMS: Nurse Practitioner) · Pediatric Nurse Practitioner · Newark, NJ
- NPI 1730597360
- Accepts Medicare
- 14 yrs in practice
- Licensed in 2 states
- Female
- Solo practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
201 Lyons Ave
Newark, NJ 071122027
(973) 926-7000 - Additional location
-
3601 A St
Philadelphia, PA 191341043
(215) 427-5000 - Mailing address
-
60 Oak Pl
Fair Haven, NJ 077043510
Credentials & registration
- NPI registered
- July 2014 — 12 yrs on file
- Profile last updated
- August 26, 2025
- Year of graduation
- 2012 — 14 yrs since
- Specialty taxonomy
- 363LP0200X — NUCC code
- State licenses (2)
- New Jersey #26NJ0048730 · New York #382415
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1730597360. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$186
Transactions
11
Manufacturers
5
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Azurity Pharmaceuticals, INC. | 4 | $65.89 | |
| Neurelis, INC. | 3 | $47.88 | |
| Tolmar, INC. | 2 | $30.48 | |
| Philips North America LLC | 1 | $21.40 | |
| Jazz Pharmaceuticals INC. | 1 | $19.93 |
By nature of payment
Frequently asked questions
What is Dr. Kelly Thibault's medical specialty?
Dr. Kelly Thibault practices Pediatric Nurse Practitioner in Newark, NJ.
Where does Dr. Kelly Thibault practice?
Dr. Kelly Thibault practices at 201 Lyons Ave, Newark, NJ 071122027. Office phone: 9739267000.
What is Dr. Kelly Thibault's NPI?
Dr. Kelly Thibault's National Provider Identifier (NPI) is 1730597360, issued by NPPES.
Does Dr. Kelly Thibault accept Medicare assignment?
Yes. Dr. Kelly Thibault accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.