Individual provider Active NPI

Kimberly B Tighe, PA

  • Physician Assistant
  • Stoneham, MA
National Provider Identifier
1093080830
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA4359 Issued in MA
Practice address
92 Montvale Ave
Suite 1400
Stoneham, MA 02180-3647
Phone
(781) 279-7040
Fax
(781) 279-8430
NPI assigned
Mar 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA4359 MA Primary

Addresses

Primary practice location

92 Montvale Ave
Suite 1400
Stoneham, MA 02180-3647

Mailing address

300 Mount Auburn St 505
Cambridge, MA 02138-5665
Phone (617) 491-6766

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140416001467 MA Practitioner - Physician Assistant 0042442568 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New England Baptist Medical Associates, Inc.Group PAC ID 2365439783, 77 clinicians

Practice addresses (Care Compare)

125 Parker Hill Ave
Boston, MA 02120-2847
Phone (617) 754-5800

Hospital & facility affiliations

  • New England Baptist Hospital Hospital, Boston, MA, CCN 220088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Orthopedics, LLC CurrentSince Dec 20, 2017 Accepting new patients
Plymouth Bay Orthopedic Associates Inc. CurrentSince Jan 6, 2020 Accepting new patients

Locations

95 Tremont St
Ste 1
Duxbury, MA 02332
Phone (781) 934-2400

2 Pond Park Rd
Ste 102
Hingham, MA 02043
Phone (781) 337-5555

41 Resnik Rd
Plymouth, MA 02360
Phone (781) 934-2400

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1093080830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MOUNT AUBURN ST 505",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385665",
            "telephone_number": "617-491-6766",
            "fax_number": "617-491-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE",
            "address_2": "SUITE 1400",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803647",
            "telephone_number": "781-279-7040",
            "fax_number": "781-279-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIGHE",
        "first_name": "KIMBERLY",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-13",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

Verify at the official NPI Registry.