Individual provider Active NPI

Kristine Marie Tingley, CNP, NNP-BC

  • Neonatal Nurse Practitioner
  • Dover, NH
National Provider Identifier
1023273265
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
048573-23 Issued in NH
Practice address
789 Central Ave
Dover, NH 03820-2526
Phone
(603) 740-2263
Fax
(603) 740-2402
NPI assigned
Jul 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN216454 MA
Critical Care Neonatal Nurse Practitioner 363LN0005X 5671 CT
Critical Care Pediatric Nurse Practitioner 363LP0222X RN216454 MA
Neonatal Nurse Practitioner 363LN0000X 048573-23 NH Primary

Addresses

Primary practice location

789 Central Ave
Dover, NH 03820-2526

Mailing address

PO Box 412503
Boston, MA 02241-2503
Phone (603) 740-2413

Other practice location 1

55 Fruit St
Boston, MA 02114-2621
Phone (617) 724-4310

Other identifiers 1

IdentifierTypeStateIssuer
3100542MedicaidNH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ktingley24403@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NH, MA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140415000374 CT Practitioner - Nurse Practitioner 9537391156 Reassigns benefits to 1 organization
I20150522001393 NH Practitioner - Nurse Practitioner 9537391156 Reassigns benefits to 1 organization
I20161004001928 MA Practitioner - Nurse Practitioner 9537391156 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5671CTMDSpeech-Language Pathologist
048573-23NHMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Aug 15, 2020 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Jan 18, 2021 Accepting new patients
General Hospital Corp Current Accepting new patients
Martha'S Vineyard Hospital, Inc. CurrentSince Aug 11, 2025 Accepting new patients
The General Hospital Corporation CurrentSince Aug 15, 2020 Accepting new patients
Martha'S Vineyard Hospital, Inc. CurrentSince Aug 11, 2025 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Jan 18, 2021 Accepting new patients
Martha'S Vineyard Hospital, Inc. Past Accepting new patients
Wentworth Douglass Hospital Past Accepting new patients
Martha'S Vineyard Hospital Nurse Practitioner Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1 Hospital Rd
Oak Bluffs, MA 02557
Phone (508) 684-4500

789 Central Ave
#2
Dover, NH 03820
Phone (603) 740-2503

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

8 Prospect St
Nashua, NH 03060
Phone (603) 281-9275

Interoperability endpoints

  • Direct secure messaging: ktingley24403@umassmemorial.direct-ci.com
  • Direct secure messaging: tingley.kristine.mgh@direct.partners.masshiway.net

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1023273265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412503",
            "telephone_number": "603-740-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-740-2263",
            "fax_number": "603-740-2402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-724-4310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TINGLEY",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CNP, NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN216454",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "CT",
            "license": "5671",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "MA",
            "license": "RN216454",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NH",
            "license": "048573-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3100542",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktingley24403@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "119 Belmont St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "119 Belmont St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.