VERNON INTEGRATIVE MEDICAL GROUP LLC (NPI# 1114175627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114175627 |
| Entity Type | Organization |
| Organization Name | VERNON INTEGRATIVE MEDICAL GROUP LLC |
| Practice Address |
10 Winthrop St Worcester MA 01604 |
| Practice Telephone | 5087549950 |
| Practice Fax Number | 5087542592 |
| Mailing Telephone | 5087549950 |
| Mailing Fax Number | 5087542592 |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2012-09-20 |
| Authorized Official Name | DR. JON TRISTER (MD INTERNAL MEDICINE) |
| Authorized Official Telephone | 5087549950 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 80587 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HARVARD PILGRIM | 66212 | 01 | |
| UNITED HEALTH CARE | 0400053 | 01 | |
| EVERCARE | 0400664 | 01 | |
| CIGNA | 1928586 | 01 | |
| BLUE CROSS BLUE SHIELD | J16290 | 01 | |
| MA | AETNA | 5841132 | 01 |
| NETWORK HEALTH | 985162 | 01 | |
| MA | NATIONAL SUPPLIER CLEARINGHOUSE | 6141990001 | 01 |
| MA | 3144941 | 05 | |
| FALLON | 29736 | 01 | |
| MA | BMCHP | 43899 | 01 |
| TUFTS | 080587 | 01 | |
| MA | 110082379A | 05 | |
| HEALTH NEW ENGLAND | 33586 | 01 |
| Street Address |
10 WINTHROP ST |
| City | WORCESTER |
| State | MA |
| Zip Code | 01604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962408971 | David W. Connors, Md, P.C. | Specialist | 10 Winthrop St, Worcester, MA 01604-4435 | 2005-06-23 |
| 1437500055 | Firstcare Dermatology of Worcester, LLC | Dermatology | 10 Winthrop St, Worcester, MA 01604-4435 | 2016-06-24 |
| 1598114761 | Cale Forgues | Dentist | 10 Winthrop St, Worcester, MA 01604-4435 | 2016-06-08 |
| 1659758977 | Peter P. Tomaiolo Md, PC | Clinic/Center | 10 Winthrop St, Worcester, MA 01604-4435 | 2015-05-06 |
| 1417334129 | Jessica Kennen | Registered Nurse | 10 Winthrop St, Worcester, MA 01604-4435 | 2015-05-01 |
| 1326315862 | Vernon Hill Pediatric Dentistry | Dentist | 10 Winthrop St, #317/318, Worcester, MA 01604-4435 | 2011-11-29 |
| 1982912481 | Himabindu Muddana | Pediatrics | 10 Winthrop St, Dr. Babu Pediatrics, PC, Worcester, MA 01604-4435 | 2010-09-17 |
| 1881829299 | Worcester Orthodontics, PC | Dentist | 10 Winthrop St, #217, Worcester, MA 01604-4435 | 2009-05-29 |
| 1669624888 | Jungsoo Moon | Dentist | 10 Winthrop St, Worcester, MA 01604-4435 | 2008-10-21 |
| 1205086980 | Scheffel Foot Center, PC | Podiatrist | 10 Winthrop St, Worcester, MA 01604-4435 | 2008-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839832 | Nicole Elizabeth Lewandrowski | Student in an Organized Health Care Education/Training Program | Pathology-1 Innovation Drive, Biotech 3, Worcester, MA 01604 | 2020-04-03 |
| 1285123034 | Sandra Jean Golden | Social Worker | 240 Belmont Street, Worcester, MA 01604 | 2018-05-08 |
| 1669961348 | Cindy Truong Choe | Behavior Technician | 330 Southwest Cutoff Suite 203, Worcester, MA 01604 | 2018-05-08 |
| 1013412915 | Michelle Marie Gaudet | Behavioral Analyst | 330 Southwest Cutoff, Suite 203, Worcester, MA 01604 | 2018-03-24 |
| 1104336593 | Younghwa Kim | Counselor | 2 Granite Street, Worcester, MA 01604 | 2017-10-11 |
| 1134640857 | Desiree Oquendo | Developmental Therapist | 43 Dillon Street, Worcester, MA 01604 | 2017-07-03 |
| 1457803686 | Reliable Home Care Services | Foster Care Agency | 35a Houghton Strret, Worcester, MA 01604 | 2016-11-04 |
| 1639530876 | Emily Capstick | Counselor | 81 Plantation Steet, Worcester, MA 01604 | 2016-03-16 |
| 1144696519 | Christian Caban I | Developmental Therapist | 25 Orient St, Worcester, MA 01604 | 2015-08-19 |
| 1750770160 | Ayanna Ortiz | Developmental Therapist | 16 Bangor St, Worcester, MA 01604 | 2015-01-22 |
| Find all providers in zip 01604 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649886235 | Elizabeth Muhia | Internal Medicine | 19 Crown St Apt 15, Worcester, MA 01609-2097 | 2020-09-18 |
| 1821614892 | Lyndia Personnat | Internal Medicine | 123 Summer St Ste 200, Worcester, MA 01608-1216 | 2020-06-24 |
| 1871007344 | Shekhar Patil | Internal Medicine | 123 Summer St Ste 120, Worcester, MA 01608-1216 | 2017-11-20 |
| 1770036451 | Gyu Cheol Choi | Internal Medicine | 1 W Boylston St # 2700, Worcester, MA 01605-1265 | 2016-07-28 |
| 1528449311 | Jyothi Margapuri | Internal Medicine | 55 Lake Ave N Apt A16, Worcester, MA 01655-0002 | 2015-06-17 |
| 1972935070 | Vernon Integrative Medical Group, LLC | Internal Medicine | 141 Massasoit Rd, Worcester, MA 01604-3318 | 2013-07-31 |
| 1437461092 | Mohammed Mohaialdeen Mohammed | Internal Medicine | 285 Plantation St, Worcester, MA 01604-7701 | 2010-07-11 |
| 1447561204 | Samson H Hanka | Internal Medicine | 102 Shore Dr Ste 303, Worcester, MA 01605-3154 | 2010-06-27 |
| 1972823870 | Chidimma I Okoli | Internal Medicine | 100 Grove St Ste 210, Worcester, MA 01605 | 2010-06-03 |
| 1750548996 | Abdulkadir Omer | Internal Medicine | 123 Summer St Ste 535, Worcester, MA 01608-1216 | 2008-05-16 |
| Find all providers in WORCESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.