Individual provider Active NPI

Janis L Puibello, RN CS

  • Family Nurse Practitioner
  • Cambridge, MA
National Provider Identifier
1396717161
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
137217 Issued in MA
Practice address
77 Mass Ave
Medical E23-395
Cambridge, MA 02139-4301
Phone
(617) 253-1311
NPI assigned
Feb 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 137217 MA Primary

Addresses

Primary practice location

77 Mass Ave
Medical E23-395
Cambridge, MA 02139-4301

Mailing address

PO Box 425789
Medical E23-395
Cambridge, MA 02142-0015
Phone (617) 253-0556

Other identifiers 1

IdentifierTypeStateIssuer
NP2813OtherMABLUE CROSS

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
I20060208000418 MA Practitioner - Nurse Practitioner 3375558620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts Institute of TechnologyGroup PAC ID 5597658666, 55 clinicians

Practice addresses (Care Compare)

25 Carleton St
Cambridge, MA 02142-1323
Phone (617) 258-6896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
137217MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Institute of Technology CurrentSince Oct 4, 2000 Accepting new patients

Locations

25 Carleton St
Cambridge, MA 02142
Phone (617) 253-0556

77 Massachusetts Ave
#E23308
Cambridge, MA 02139
Phone (617) 258-5332

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396717161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425789",
            "address_2": "MEDICAL E23-395",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021420015",
            "telephone_number": "617-253-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MASS AVE",
            "address_2": "MEDICAL E23-395",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394301",
            "telephone_number": "617-253-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUIBELLO",
        "first_name": "JANIS",
        "middle_name": "L",
        "credential": "RN CS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "137217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "NP2813",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.