Active NPI
Christine Tebaldi, NP
- Psychiatric/Mental Health Nurse Practitioner
- Belmont, MA
National Provider Identifier
1437162906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- RN217763
- Practice address
- 115 Mill St
Belmont, MA 02478-1064 - Phone
- (585) 317-9082
- NPI assigned
- Aug 14, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 217763 | MA | |
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | F#400637-1 | NY | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN217763 | MA | Primary |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 484639-1 | NY |
Addresses
Primary practice location
115 Mill St
Belmont, MA 02478-1064
Mailing address
115 Mill St
Belmont, MA 02478-1064
Phone (585) 317-9082
Other practice location 1
55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-3562
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000688401 | Other | MA | MEDICARE |
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
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 484639-1 | NY | MD | Psychiatric/Mental Health Registered Nurse |
| F#400637-1 | NY | MD | Adult Psychiatric/Mental Health Registered Nurse |
| 217763 | MA | MD | Child & Adolescent Psychiatry Physician |
| RN217763 | MA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sturdy Health, Inc. | Past | 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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Mansfield, MA
- NPI 1871515874
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1437162906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 MILL ST",
"city": "BELMONT",
"state": "MA",
"postal_code": "024781064",
"telephone_number": "585-317-9082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 MILL ST",
"city": "BELMONT",
"state": "MA",
"postal_code": "024781064",
"telephone_number": "585-317-9082"
}
],
"practiceLocations": [
{
"address_1": "55 Lake Ave N",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016550002",
"country_code": "US",
"telephone_number": "508-334-3562",
"fax_number": "508-421-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TEBALDI",
"first_name": "CHRISTINE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "MA",
"license": "217763",
"primary": false
},
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "NY",
"license": "F#400637-1",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MA",
"license": "RN217763",
"primary": true
},
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "NY",
"license": "484639-1",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "000688401",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Belmont, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.