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VERNON INTEGRATIVE MEDICAL GROUP LLC
NPI 1114175627
Internal Medicine in Worcester, MA

Active since September 09, 2008CLIA 22D2072006 · Waiver
10 WINTHROP ST, WORCESTER, MA 01604(508) 754-9950(508) 754-2592 Get Directions Write a Review

NPPES record last updated: September 20, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Vernon Integrative Medical Group Llc NPPES

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

VERNON INTEGRATIVE MEDICAL GROUP LLC (NPI 1114175627) is a healthcare organization registered as an internal medicine in Worcester, Massachusetts and active in the NPI registry since September 2008. The organization holds a CLIA Waiver certificate valid through January 22, 2028 and lists Jon Trister, Md Internal Medicine, as its authorized official.

NPPES Registry Identity

NPI1114175627
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameVERNON INTEGRATIVE MEDICAL GROUP LLC
Location Address10 WINTHROP STWorcester, MA 01604
Mailing Address10 Winthrop StWorcester, MA 01604 · (508) 754-9950 · Fax (508) 754-2592
Phone(508) 754-9950
Fax(508) 754-2592
Organization SubpartNo
Authorized OfficialJon TristerMd Internal Medicine · (508) 754-9950
Enumeration DateSeptember 9, 2008
Last NPPES UpdateSeptember 20, 2012
✔ NPI 1114175627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MA · 80587
Definition
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.
10 WINTHROP ST, Worcester, MA 01604
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Other Identifiers 17

Other43899MA · Bmchp
Medicare UPING12349MA
Medicaid110082379AMA
Other29736Fallon
OtherJ16290Blue Cross Blue Shield
Other080587Tufts
Other6141990001MA · National Supplier Clearinghouse
Other985162Network Health
Medicare PIN0008944MA
Medicare NSC6141990001MA
Other0400664Evercare
Other1928586Cigna
Other5841132MA · Aetna
Other66212Harvard Pilgrim
Other0400053United Health Care
Other33586Health New England
Medicaid3144941MA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D2072006

Vernon Integrative Medical Group LLC · Worcester, MA
Active · expires Jan 22, 2028
CLIA Number22D2072006
Laboratory TypePhysician Office
Certificate Effective DateJanuary 23, 2026
Certificate Expiration DateJanuary 22, 2028
Laboratory DirectorJon Trister
Laboratory Phone(508) 754-9950
Laboratory LocationVernon Integrative Medical Group LLC141 Massasoit Road, Worcester, MA 01604
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

JAIN MEDICAL GROUP PC
Family Medicine
10 WINTHROP ST
WORCESTER, MA 01604
Worcester County (508) 799-4100
MCGILLICUDDY & SUNGARIAN, M.D'S, LLP
Neurological Surgery
10 WINTHROP ST
WORCESTER, MA 01604
Worcester County (508) 752-6381
DR. PETER P TOMAIOLO MD
Specialist
10 WINTHROP ST, SUITE 311
WORCESTER, MA 01604
Worcester County (508) 755-6129
CHARANJIT S RAO MD PC
Surgery (Vascular Surgery)
10 WINTHROP ST
WORCESTER, MA 01604
Worcester County (508) 756-2244
JANG B. SINGH, M,D,PC.
Internal Medicine (Cardiovascular Disease)
10 WINTHROP ST, VERNON MEDICAL CENTER
WORCESTER, MA 01604
Worcester County (508) 792-2336
DR. FREDERICK CHEUNG
Dentist (Orthodontics and Dentofacial Orthopedics)
10 WINTHROP ST, #210
WORCESTER, MA 01604
Worcester County (508) 755-2207
DR. PAULETTE R KIMBALL-WREN MD
Pediatrics
10 WINTHROP ST
WORCESTER, MA 01604
Worcester County (508) 753-3120
KIRTI NAGPAL M.D.
Pediatrics
10 WINTHROP ST
WORCESTER, MA 01604
Worcester County (508) 797-3430

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 Vernon Integrative Medical Group LLC's NPI number?

The NPI number for Vernon Integrative Medical Group LLC is 1114175627. It was assigned to this organization in the NPPES registry on September 9, 2008.

Where is Vernon Integrative Medical Group LLC located?

Vernon Integrative Medical Group LLC is located at 10 Winthrop St, Worcester, MA 01604. The listed phone number is (508) 754-9950.

What is Vernon Integrative Medical Group LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Vernon Integrative Medical Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2072006) is associated with this NPI, valid through January 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Vernon Integrative Medical Group LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Vernon Integrative Medical Group LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Vernon Integrative Medical Group LLC was last updated on September 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.