OrganizationActive
Tiffany Douglas
NPI 1629448964 · Clinic/Center · Boston, MA
Provider details
- NPI number
- 1629448964
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tiffany Douglas, Fnp/ Primary Care Provider(864) 423-3561
- License
- RN2299504 (MA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1 Soldiers Field Park
Apt 501
Boston, MA 02163-1722
Phone: (864) 423-3561
Street-level locationGet directions
Mailing address
1 Soldiers Field Park
Boston, MA 02163-1722
Registry dates
- Enumerated
- 2015-09-29
- Last updated
- 2015-09-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.