Tracy Otubu
Nurse Practitioner, Psych/Mental Health in Needham, MA. Individual provider (NPI-1).
NPI number1194516773
StatusActive
Last updated in NPPESJan 13, 2026
Details
- NPI
- 1194516773
- Entity type
- Individual (NPI-1)
- Name
- Tracy Otubu
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 14, 2025
- Certification date
- Jan 13, 2026
- Last updated
- Jan 13, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | RN2365786 | MA | Yes |
Practice location
322 Reservoir StNeedham, MA 02494-3169
Phone 877-920-6583
Mailing address
867 Boylston St Fl 5Boston, MA 02116-2774
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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