Maxine A Theriot, MD - Medicare Family Practice in Poplar Bluff, MO

Maxine A Theriot, MD is a medicare enrolled "Preventive Medicine - Undersea And Hyperbaric Medicine" physician in Poplar Bluff, Missouri. She went to Loma Linda University School Of Medicine and graduated in 1994 and has 30 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Poplar Bluff Hma Physician Management, Llc and her current practice location is 3098 Oak Grove Rd, Poplar Bluff, Missouri. You can reach out to her office (for appointments etc.) via phone at (573) 686-8199.

Maxine A Theriot is licensed to practice in Missouri (license number 2022047286) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1194874628.

Contact Information

Maxine A Theriot, MD
3098 Oak Grove Rd,
Poplar Bluff, MO 63901-8938
(573) 686-8199
(573) 686-8398



Physician's Profile

Full NameMaxine A Theriot
GenderFemale
SpecialityFamily Practice
Experience30 Years
Location3098 Oak Grove Rd, Poplar Bluff, Missouri
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Maxine A Theriot attended and graduated from Loma Linda University School Of Medicine in 1994
  NPI Data:
  • NPI Number: 1194874628
  • Provider Enumeration Date: 01/10/2007
  • Last Update Date: 07/13/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 0648296525
  • Enrollment ID: I20230322000964

Medical Identifiers

Medical identifiers for Maxine A Theriot such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1194874628NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine J9578 (Texas)Secondary
2083P0011XPreventive Medicine - Undersea And Hyperbaric Medicine J9578 (Texas)Secondary
2083P0011XPreventive Medicine - Undersea And Hyperbaric Medicine 2022047286 (Missouri)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Ozark Home HealthcarePoplar bluff, MOHome health agency
Comfort Care Home Health Agency, IncDoniphan, MOHome health agency
Visiting Nurse Assn Of Southeast Missouri, IncKennett, MOHome health agency
Elara CaringDexter, MOHome health agency
Poplar Bluff Regional Medical CenterPoplar bluff, MOHospital
Southeasthealth Center Of Stoddard CountyDexter, MOHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Poplar Bluff Hma Physician Management, Llc509276970337

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Maxine A Theriot allows following entities to bill medicare on her behalf.
Entity NamePoplar Bluff Hma Physician Management, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598710147
PECOS PAC ID: 5092769703
Enrollment ID: O20050307000013

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Maxine A Theriot is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Maxine A Theriot, MD
709 W Rusk St Ste B,
Rockwall, TX 75087-3600

Ph: (972) 786-0140
Maxine A Theriot, MD
3098 Oak Grove Rd,
Poplar Bluff, MO 63901-8938

Ph: (573) 686-8199

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Preventive Medicine Doctors in Poplar Bluff, MO


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