Individual provider Active NPI

Kathryn Tribulski, AUD

  • Audiologist
  • Boston, MA
National Provider Identifier
1629524707
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
SP-1116-AU Issued in MA
Practice address
800 Washington St
Box 823
Boston, MA 02111-1552
Phone
(617) 636-5300
Fax
(617) 636-0583
NPI assigned
Aug 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X SP-1116-AU MA Primary

Addresses

Primary practice location

800 Washington St
Box 823
Boston, MA 02111-1552

Mailing address

800 Washington St
Box 823
Boston, MA 02111-1552
Phone (617) 636-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170412000794 MA Practitioner - Qualified Audiologist 9133405822 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP-1116-AUMAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tufts Medical Center, Inc. CurrentSince Mar 7, 2017 Accepting new patients
Tufts Medical Center, Inc. CurrentSince Mar 7, 2017 Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#823
Boston, MA 02111
Phone (617) 636-5300

750 Washington St
#833
Boston, MA 02111
Phone (617) 636-4800

Organizations & group practices 2

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": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1629524707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "BOX 823",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5300",
            "fax_number": "617-636-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "BOX 823",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5300",
            "fax_number": "617-636-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIBULSKI",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "SP-1116-AU",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.