Individual provider Active NPI

Christina Noelle Otis, APRN, MSN, FNP-C

  • Nurse Practitioner
  • Brockton, MA
National Provider Identifier
1679252795
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2380082 Issued in MA
Practice address
63 Main St
Brockton, MA 02301-4042
Phone
(508) 559-6699
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2380082 MA Primary

Addresses

Primary practice location

63 Main St
Brockton, MA 02301-4042

Mailing address

63 Main St
Brockton, MA 02301-4042
Phone (508) 559-6699

Other names 1

  • Christina Noelle Pace Other name

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
I20250228002713 MA Practitioner - Nurse Practitioner 3971024365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

63 Main St
Brockton, MA 02301-4042
Phone (508) 559-6699

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN2380082MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brockton Neighborhood Health Center CurrentSince Dec 19, 2024 Accepting new patients
Brockton Neighborhood Health Center, Inc. CurrentSince Dec 19, 2024 Accepting new patients

Locations

100 S Shore Dr
Ste 200
East Haven, CT 06512
Phone (217) 433-2804

63 Main St
Brockton, MA 02301
Phone (508) 559-6696

Interoperability endpoints

  • FHIR API: https://epicproxy.et1290.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

Hospital & facility affiliations 2

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": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1679252795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "CHRISTINA",
        "middle_name": "NOELLE",
        "credential": "APRN, MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2380082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "PACE",
            "middle_name": "NOELLE",
            "credential": "APRN, MSN, FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.