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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

THERESA GRACE BOOTHBY MSN, APRN, NP-C
NPI 1053840389
Nurse Practitioner - Family in New London, CT

Active since June 09, 2017PECOS Enrolled
1 SHAWS CV, NEW LONDON, CT 06320(860) 447-8304 Get Directions Write a Review

NPPES record last updated: July 11, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 11, 2026, Sep 5, 2019, Jul 27, 2017 and 1 more (4 updates tracked since 2017).

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

NPI1053840389
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTHERESA GRACE BOOTHBYCredential: MSN, APRN, NP-C
Location Address1 SHAWS CVNew London, CT 06320-4902
Mailing Address16 Westside Dr Apt 117North Grosvenordale, CT 06255-2162 · (508) 949-7460
Phone(860) 447-8304
Sole ProprietorNo
Enumeration DateJune 9, 2017
Last NPPES UpdateJuly 11, 20264 updates tracked since enumeration
NPPES CertifiedJuly 11, 2026
✔ NPI 1053840389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in MA · RN213709✔ Licensed in CT · 12.010276
Also ListedRegistered NurseTaxonomy 163W00000X · License RN213709 (MA), 10.187256 (CT)
1 SHAWS CV, New London, CT 06320
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

SKYLA YOUNG CEDANO APRN
Nurse Practitioner
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
MELISSA MILVENAN RN, APRN
Nurse Practitioner
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
STEPHANIE HOWELLS RDH
Dental Hygienist
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
LAURIE FELKER RN
Registered Nurse
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
MARIE SALVEMINI LPC
Counselor (Professional)
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
MEREDITH WANIK APRN
Nurse Practitioner (Psychiatric/Mental Health)
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
MS. ERICA PRESTON PSYD
Psychologist (Clinical)
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
SAMUEL BENEDICT MAYNARD APRN
Nurse Practitioner (Family)
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304

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.

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 25 days 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.