CASSIA TIBBLES – Family Nurse Practitioner, NPI 1104387570

CASSIA TIBBLES is a healthcare provider. based in Woburn, Massachusetts. specializing in NURSE PRACTITIONER. They hold a License No. 067704-21 (NH). The NPI Number for CASSIA TIBBLES is 1104387570

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
CASSIA TIBBLES
NPI
1104387570
Phone
(603) 769-1542
Address
7 CERQUA ST
Enumeration Date
28 March 2019
Last Update Date
23 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9785194114
Graduation Year
2019 (7 years ago)
PAC ID
3173900214
Group Practice PAC ID
1153658851
Professional Enrollment ID
I20220511002085
Address ID
NH030603676NA166XXSTXX306
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

8,971 NURSE PRACTITIONER in MA

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Provider Addresses for CASSIA TIBBLES

  • 7, Cerqua Street, Woburn, Middlesex County, Massachusetts, 01801, United States

    WOBURN, MA 018015302

    Phone: (603) 769-1542

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-09-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220511002085INurse PractitionerNHTBD
I20220908002436INurse PractitionerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99291Critical care, first 30-74 minutes2323$0
View full utilization report →

Insurance plans in this area (ZIP 01801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153658851View full group profile
NameSpecialtyState
-MA
Physician AssistantNH
Pulmonary Disease, Internal Medicine, Critical Care (Intensivists), Internal MedicineNH
Nurse PractitionerNH
Nurse PractitionerNH
Nurse PractitionerMA
Pulmonary DiseaseME
Nurse PractitionerMA
Critical Care (Intensivists)MA
Internal MedicineIL

Reviews

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Frequently asked questions

What number should I use to identify CASSIA TIBBLES for billing?
Administrative and clinical systems typically use NPI 1104387570 for CASSIA TIBBLES.
Should I treat CASSIA TIBBLES as an active provider?
Patients and plans typically see CASSIA TIBBLES as active in the national extract.
What does the directory say CASSIA TIBBLES does?
Insurance directories may phrase it differently, but here CASSIA TIBBLES maps to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to CASSIA TIBBLES?
The directory associates CASSIA TIBBLES with Woburn, Massachusetts. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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