Active NPI
Amanda H Thibert, NP
- Pediatric Nurse Practitioner
- Boston, MA
National Provider Identifier
1245208248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 177950
- Practice address
- 133 Brookline Ave
Boston, MA 02215-3904 - Phone
- (617) 421-1000
- Fax
- (617) 421-6084
- NPI assigned
- Mar 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 177950 | MA | Primary |
| Nurse Practitioner | 363L00000X | 177950 | MA |
Addresses
Primary practice location
133 Brookline Ave
Boston, MA 02215-3904
Mailing address
133 Brookline Ave FL 9
Boston, MA 02215-3904
Phone (617) 421-8888
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0357685 | Medicaid | MA | |
| NP9991 | Other | MA | BLUE CROSS |
| 39176 | Other | MA | HARVARD PILGRIM |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | athibertnp5455@direct.atrius.masshiway.net |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 177950 | MA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1245208248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 BROOKLINE AVE FL 9",
"city": "BOSTON",
"state": "MA",
"postal_code": "022153904",
"telephone_number": "617-421-8888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 BROOKLINE AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "022153904",
"telephone_number": "617-421-1000",
"fax_number": "617-421-6084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIBERT",
"first_name": "AMANDA",
"middle_name": "H",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-08",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MA",
"license": "177950",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "177950",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0357685",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "NP9991",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "39176",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "athibertnp5455@direct.atrius.masshiway.net",
"affiliation": "N",
"address_1": "133 Brookline Ave",
"city": "Boston",
"state": "MA",
"country_code": "US",
"postal_code": "022153904",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.