THERESA GRACE BOOTHBY MSN, APRN, NP-C
NPI 1053840389
Nurse Practitioner - Family in New London, CT
About Theresa Grace Boothby Msn, Aprn, Np-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THERESA GRACE BOOTHBY MSN, APRN, NP-C (NPI 1053840389) is an individual family provider in New London, Connecticut, licensed in Massachusetts (RN213709) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Theresa Grace Boothby Msn, Aprn, Np-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Theresa Boothby reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Middletown, CT 06457
- Reassigned Medicare billing, Connecticut enrollment
- 390 clinicians in this Medicare group
Baltimore, MD 21202
- Reassigned Medicare billing, Connecticut enrollment
- 2 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 06320 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Theresa Boothby's NPI number?
The NPI number for Theresa Boothby is 1053840389. It was assigned to this individual provider in the NPPES registry on June 9, 2017.
Where is Theresa Boothby located?
Theresa Boothby practices at 1 Shaws Cv, New London, CT 06320. The listed phone number is (860) 447-8304.
What is Theresa Boothby's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Theresa Boothby enrolled in Medicare?
Yes. Theresa Boothby is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Theresa Boothby's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Theresa Boothby reassigns Medicare benefits to 2 organizations: Community Health Center Inc (Middletown, CT) and Kinstead Provider Group, P.A. (Baltimore, MD). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Theresa Boothby's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Theresa Boothby was last updated on July 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Theresa Grace Boothby, MSN, APRN, NP-C · NPI 1053840389
Family physician in New London, Connecticut. Individual provider, active in the CMS NPPES registry since June 9, 2017.
## Identity
- **NPI:** 1053840389 (Entity type: Individual)
- **Enumerated:** June 9, 2017
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** RN213709 (Massachusetts)
- **Sole proprietor:** No
## Practice location
- **Address:** 1 SHAWS CV, New London, CT 06320-4902
- **Phone:** (860) 447-8304
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Community Health Center Inc (NPI 1952591851, Middletown, CT); Kinstead Provider Group, P.A. (NPI 1568338473, Baltimore, MD) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 11, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1053840389) · Data from the CMS NPPES public registry.