Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MARY TIBBETTS PA-C
NPI 1194511212
Physician Assistant in Boston, MA

Active since April 16, 2025
55 FRUIT ST, BOSTON, MA 02114(617) 724-4100(617) 726-7415 Get Directions Write a Review

NPPES record last updated: November 4, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mary Tibbetts Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY TIBBETTS PA-C (NPI 1194511212) is an individual physician assistant in Boston, Massachusetts, licensed in Massachusetts (PA103158) and active in the NPI registry since April 2025.

NPPES Registry Identity

NPI1194511212
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMARY TIBBETTSCredential: PA-C
Location Address55 FRUIT STBoston, MA 02114-2696
Mailing Address36 Iona StBoston, MA 02131-2761 · (978) 888-3526
Fax(617) 726-7415
Sole ProprietorNo
Enumeration DateApril 16, 2025
Last NPPES UpdateNovember 4, 2026
NPPES CertifiedNovember 4, 2026
✔ NPI 1194511212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MA · PA103158
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
55 FRUIT ST, Boston, MA 02114

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.

Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114

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 Mary Tibbetts's NPI number?

The NPI number for Mary Tibbetts is 1194511212. It was assigned to this individual provider in the NPPES registry on April 16, 2025.

Where is Mary Tibbetts located?

Mary Tibbetts practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 724-4100.

What is Mary Tibbetts's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Mary Tibbetts was last updated on November 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.