Kennedy Tambi, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN237828 Issued in MA

Practice address

64 Main St Apt 35B
Stoneham, MA 02180-3384

Phone

(617) 286-3364

NPI assigned

Oct 16, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kennedy.tambi.p1@direct.elementcare.nextgenshare.com

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.

• Starlight Behavioral Health LLC

  • Psychiatry Physician
  • Woburn, MA
  • NPI 1477377539
  NPD Authorized official
• Supportive Behavioral Care of Ma LLC

  • Clinical Psychologist
  • Needham, MA
  • NPI 1780115519
  NPD

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1932707445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 MAIN ST APT 35B",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803384",
            "telephone_number": "617-286-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 MAIN ST APT 35B",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803384",
            "telephone_number": "617-286-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMBI",
        "first_name": "KENNEDY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-16",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN237828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020860",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fitchburg",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "68 Charles St",
            "city": "Fitchburg",
            "state": "MA",
            "country_code": "US",
            "postal_code": "014207742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dhiren K. Sutaria, M.D.
• Hannah Suuberg, M.S. CCLS
• Eileen Svendsen, ACNP-BC
• Swanson Fitness, Inc.
• Laurel Tillinghast Tainsh, MD, MHS
• Kathleen Thai, OD
• Thuzar Thein, MD/PHD
• Beatrix Sylvie Thomas, MD
• Mary Shannon Thomas, LICSW
• Peter N Tiffany, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Stoneham, MA
• Providers in Stoneham, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.