Individual provider Active NPI

Tamires Tiburtino

  • Psychologist
  • New Haven, CT
National Provider Identifier
1053005702
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
55 Lock St
New Haven, CT 06511-3603
Phone
(203) 432-0290
NPI assigned
Jun 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

55 Lock St
New Haven, CT 06511-3603

Mailing address

133 Portsea St Unit 2
New Haven, CT 06519-2219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1053005702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 PORTSEA ST UNIT 2",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065192219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LOCK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113603",
            "telephone_number": "203-432-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBURTINO",
        "first_name": "TAMIRES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.