NPIMap

Individual provider Active NPI

Carrie D Tibbles, M.D.

  • Emergency Medicine Physician
  • Boston, MA
National Provider Identifier
1528159605
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
210090 Issued in MA
Practice address
1 Deaconess Rd
Boston, MA 02215-5321
Phone
(617) 754-2344
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 210090 MA Primary

Addresses

Primary practice location

1 Deaconess Rd
Boston, MA 02215-5321

Mailing address

851 Emerson Gardens Rd
Lexington, MA 02420-2614
Phone (617) 754-2344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080408000708 MA Practitioner - Emergency Medicine 2860579356 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Boston University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-5398

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bid-Milton Physician Associates Inc CurrentSince Oct 1, 2020 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 4, 2014 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jul 1, 2013 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Emergency Medicine CurrentSince Jul 13, 2001 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 4, 2014 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 1, 2025 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Current Accepting new patients
The General Hospital Corporation CurrentSince Apr 10, 2020 Accepting new patients
Bid-Milton Physician Associates Inc CurrentSince Oct 1, 2020 Accepting new patients
Massachusetts General Physicians Organization Inc Emergency Medicine CurrentSince Apr 10, 2020 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Nov 1, 2020 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1 Deaconess Rd
Boston, MA 02215
Phone (617) 754-2323

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

910 Washington St
Dedham, MA 02026
Phone (781) 431-1333

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

100 Highland St
Milton, MA 02186
Phone (617) 615-4000

148 Chestnut St
Needham, MA 02492
Phone (781) 453-3000

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

100 Walter J Hannon Pkwy
Ste 143
Quincy, MA 02169
Phone (617) 615-4000

Interoperability endpoints

  • Direct secure messaging: ctibbles255157@direct.bilh.masshiway.net

Organizations & group practices 11

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528159605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 EMERSON GARDENS RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024202614",
            "telephone_number": "617-754-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DEACONESS RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155321",
            "telephone_number": "617-754-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBLES",
        "first_name": "CARRIE",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "210090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.