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PREMISE HEALTH OF MASSACHUSETTS MEDICAL PC
NPI 1295039196
Clinic/Center - Primary Care in Worcester, MA

Active since January 06, 2011CLIA 22D1098588 · Waiver
440 LINCOLN ST, WORCESTER, MA 01653(508) 855-2222(508) 855-6199 Get Directions Write a Review

NPPES record last updated: February 10, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 24, 2022, Feb 10, 2020 (2 updates tracked since 2020).

About Premise Health Of Massachusetts Medical Pc NPPES

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

PREMISE HEALTH OF MASSACHUSETTS MEDICAL PC (NPI 1295039196), doing business as The Hanover Wellness Center, is a healthcare organization registered as a primary care in Worcester, Massachusetts and active in the NPI registry since January 2011. The organization holds a CLIA Waiver certificate valid through April 22, 2027 and lists Edward William Schwartz, President, as its authorized official.

NPPES Registry Identity

NPI1295039196
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePREMISE HEALTH OF MASSACHUSETTS MEDICAL PC
Location Address440 LINCOLN STWorcester, MA 01653
Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993
Phone(508) 855-2222
Fax(508) 855-6199
Organization SubpartNo
Authorized OfficialEdward William SchwartzPresident · (844) 407-7557
Enumeration DateJanuary 6, 2011
Last NPPES UpdateFebruary 10, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 10, 2026
✔ NPI 1295039196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
440 LINCOLN ST, Worcester, MA 01653
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Other Names 1

Doing Business AsThe Hanover Wellness Center

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 22D1098588

Premise Health Of Massachusetts Medical PC · Worcester, MA
Active · expires Apr 22, 2027
CLIA Number22D1098588
Laboratory TypePhysician Office
Certificate Effective DateApril 23, 2025
Certificate Expiration DateApril 22, 2027
Laboratory DirectorMs. Jillian Russell
Laboratory Phone(505) 855-2222
Laboratory LocationPremise Health Of Massachusetts Medical PC440 Lincoln Street, Worcester, MA 01653
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Premise Health Of Massachusetts Medical PC's NPI number?

The NPI number for Premise Health Of Massachusetts Medical PC is 1295039196. It was assigned to this organization in the NPPES registry on January 6, 2011. The provider is doing business as The Hanover Wellness Center.

Where is Premise Health Of Massachusetts Medical PC located?

Premise Health Of Massachusetts Medical PC is located at 440 Lincoln St, Worcester, MA 01653. The listed phone number is (508) 855-2222.

What is Premise Health Of Massachusetts Medical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Premise Health Of Massachusetts Medical PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D1098588) is associated with this NPI, valid through April 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premise Health Of Massachusetts Medical PC was last updated on February 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.