CASSANDRA THEODORIS (NP) – Acute Care Nurse Practitioner, NPI 1316411481

Acute Care Nurse Practitioner

CASSANDRA THEODORIS (NP) is a healthcare provider. based in Brockton, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. RN2312573 (MA). The NPI Number for CASSANDRA THEODORIS (NP) is 1316411481

Main info

Male

8 Years Of Experience

Accepts Medicare Assignment

Name

CASSANDRA THEODORIS (NP)

NPI

1316411481

Phone

(508) 941-7000

Address

680 Centre St

Enumeration Date

11 January 2019

Last Update Date

2 June 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

Graduation Year

2018 (8 years ago)

PAC ID

5193065696

Group Practice PAC ID

2264336528

Professional Enrollment ID

I20190320001019

Address ID

MA018050001Bu41XXXRDXX300

Telehealth

Yes

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience43

Completeness75

Years active:7State licenses:1Digital endpointsOther names

8,971 NURSE PRACTITIONER in MA

Provider Addresses for CASSANDRA THEODORIS (NP)

680 Centre St
Brockton, MA 023023308
Phone: (508) 941-7000
Fax: (508) 941-0895
Type: Location
1438;1440, Eastern Avenue, Linden, Malden, Middlesex County, Massachusetts, 02149-3199, United States
MALDEN, MA 021486112
Phone:
Type: Mailing
110, Liberty Street, Marshall Corner, Brockton, Plymouth County, Massachusetts, 02357, United States
BROCKTON, MA 023015521
Phone: (508) 894-0400
Type: Location

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: 2019-03-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20190320001019	I	Nurse Practitioner	MA	TBD

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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
99213	Established patient office or other outpatient visit, 20-29 minutes	44	40	$0

View full utilization report →

Insurance plans in this area (ZIP 02302)

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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: 2264336528View full group profile

Name	Specialty	State
ELAINA P TOWNSEND	Nurse Practitioner	MA
CHRISTINE B. THOMAS (M.D.)	-	MA
SYED KASHIF MAHMOOD (MD)	G A S T R O E N T E R O L O G Y	NY
MS. OLIMPIA P SUCIU (PA)	Physician Assistant	MA
PAUL D TEAGUE (MD)	A N E S T H E S I O L O G Y	MA