Individual provider Active NPI

Eniana Jane Tabor, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Concord, MA
National Provider Identifier
1902350408
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2310374 Issued in MA
Practice address
300 Baker Ave
Concord, MA 01742-2131
Phone
(978) 245-6171
Fax
(978) 381-5801
NPI assigned
Aug 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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 RN2310374 MA Primary

Addresses

Primary practice location

300 Baker Ave
Concord, MA 01742-2131

Mailing address

300 Baker Ave
Concord, MA 01742-2131
Phone (978) 245-6171

Other identifiers 1

IdentifierTypeStateIssuer
020860MedicaidMA

Other names 1

  • Eniana Jane Agolli Former 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
I20181115001485 MA Practitioner - Nurse Practitioner 2567716244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

169 Libbey Industrial Pkwy
Weymouth, MA 02189-3189

289 Great Rd
Suite G1
Acton, MA 01720-4768

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2310374MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Wellness & Psychiatry PLLC Psychiatric/Mental Health Current Accepting new patients
New England Center for Mental Health LLC CurrentSince Oct 1, 2018 Accepting new patients
Child and Family Psychological Services, PLLC CurrentSince Apr 12, 2021 Accepting new patients

Locations

289 Great Rd
Ste G1
Acton, MA 01720
Phone (978) 679-1200

200 Baker Ave
Ste 203
Concord, MA 01742

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

169 Libbey Park
Weymouth, MA 02189
Phone (508) 238-7766

Interoperability endpoints

  • Direct secure messaging: cfps.enianatabor@139414.advancedmd-direct.com

Organizations & group practices 3

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": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1902350408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BAKER AVE",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422131",
            "telephone_number": "978-245-6171",
            "fax_number": "978-381-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BAKER AVE",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422131",
            "telephone_number": "978-245-6171",
            "fax_number": "978-381-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABOR",
        "first_name": "ENIANA",
        "middle_name": "JANE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2310374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020860",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ENIANA",
            "last_name": "AGOLLI",
            "middle_name": "JANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.