Individual provider Active NPI

Tyra A Googe, CPNP-AC

  • Pediatric Nurse Practitioner
  • Boston, MA
National Provider Identifier
1245183011
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2333352 Issued in MA
Practice address
850 Harrison Ave.
Yacc 4
Boston, MA 02118
Phone
(617) 414-4359
NPI assigned
Feb 19, 2026
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN2333352 MA Primary

Addresses

Primary practice location

850 Harrison Ave.
Yacc 4
Boston, MA 02118

Mailing address

70 Sheafe St
Malden, MA 02148-6029

Other names 1

  • Tyra Dukes Former name

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
I20260512001480 MA Practitioner - Nurse Practitioner 6204305907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

960 Massachusetts Ave
Suite 2
Boston, MA 02118-2620

960 Massachusetts Ave
Suite 2
Boston, MA 02118-2690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2333352MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Child Health Foundation of Boston, Inc. Pediatrics PastSince Jun 30, 2011 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1771459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1245183011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 SHEAFE ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021486029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE.",
            "address_2": "YACC 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOGE",
        "first_name": "TYRA",
        "middle_name": "A",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-19",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2333352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYRA",
            "last_name": "DUKES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.