Individual provider Active NPI

Cassandra Etienne

  • Midwife
  • Brockton, MA
National Provider Identifier
1073830816
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
Practice address
63 Main St
Brockton, MA 02301-4042
Phone
(508) 559-6699
Fax
(508) 559-5073
NPI assigned
May 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X Primary
Advanced Practice Midwife 367A00000X

Addresses

Primary practice location

63 Main St
Brockton, MA 02301-4042

Mailing address

63 Main St
Brockton, MA 02301-4042
Phone (508) 559-6699

Other practice location 1

75 Francis St
Boston, MA 02115-6106
Phone (617) 732-5500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101021000371 MA Practitioner - Certified Nurse Midwife (CNM) 1759574833 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Aug 15, 2019 Accepting new patients
Brockton Neighborhood Health Center CurrentSince Aug 5, 2010 Accepting new patients
Steward Medical Group, Inc CurrentSince Aug 15, 2019 Accepting new patients
Brockton Neighborhood Health Center, Inc. CurrentSince Aug 5, 2010 Accepting new patients
Brockton Neighborhood Health Center Past Accepting new patients

Locations

63 Main St
Brockton, MA 02301
Phone (508) 559-6696

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

Interoperability endpoints

  • FHIR API: https://epicproxy.et1290.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: cetienne19203@direct.ctc.masshiway.net

Organizations & group practices 5

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": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1073830816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699",
            "fax_number": "508-559-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699",
            "fax_number": "508-559-5073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156106",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "CASSANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-03",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.