Individual provider Active NPI

Jessica Tiburtino Stad, PMHNP, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Middleboro, MA
National Provider Identifier
1659260719
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2272863 Issued in MA
Practice address
151 Campanelli Dr Ste B
Middleboro, MA 02346-1086
Phone
(508) 866-8895
NPI assigned
Jul 1, 2025
Last updated
Jul 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2272863 MA Primary

Addresses

Primary practice location

151 Campanelli Dr Ste B
Middleboro, MA 02346-1086

Mailing address

151 Campanelli Dr Ste B
Middleboro, MA 02346-1086
Phone (508) 866-8895

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
I20250912004060 MA Practitioner - Nurse Practitioner 8224531389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Huffman Enterprises IncGroup PAC ID 1153564331, 15 clinicians

Practice addresses (Care Compare)

516 Hawthorn St
Suite 4
Dartmouth, MA 02747-3733
Phone (774) 929-7420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2272863MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Huffman Enterprises, Inc CurrentSince Jul 6, 2025 Accepting new patients

Locations

516 Hawthorn St
Ste 4
North Dartmouth, MA 02747
Phone (774) 919-7420

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1659260719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 CAMPANELLI DR STE B",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023461086",
            "telephone_number": "508-866-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 CAMPANELLI DR STE B",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023461086",
            "telephone_number": "508-866-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAD",
        "first_name": "JESSICA",
        "middle_name": "TIBURTINO",
        "credential": "PMHNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-07-01",
        "certification_date": "2025-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2272863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleboro, MA

Sources for this page

Verify at the official NPI Registry.