WINOOSKI INTEGRATIVE MEDICINE PC
NPI 1619694478
Clinic/Center - Multi-Specialty in Winooski, VT
About Winooski Integrative Medicine Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WINOOSKI INTEGRATIVE MEDICINE PC (NPI 1619694478) is a healthcare organization registered as a multi-specialty in Winooski, Vermont and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through November 13, 2026 and lists Sam Russo, Principal, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Winooski Integrative Medicine Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Winooski Integrative Medicine PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 47D2272039
Winooski Integrative Medicine PC · Winooski, VTFrequently 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 Winooski Integrative Medicine PC's NPI number?
The NPI number for Winooski Integrative Medicine PC is 1619694478. It was assigned to this organization in the NPPES registry on October 24, 2022.
Where is Winooski Integrative Medicine PC located?
Winooski Integrative Medicine PC is located at 321 Main St Ste B, Winooski, VT 05404. The listed phone number is (802) 636-4133.
What is Winooski Integrative Medicine PC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Winooski Integrative Medicine PC enrolled in Medicare?
Yes. Winooski Integrative Medicine PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Winooski Integrative Medicine PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Winooski Integrative Medicine PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Winooski Integrative Medicine PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 47D2272039) is associated with this NPI, valid through November 13, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Winooski Integrative Medicine PC accept?
Health plans from Anthem Blue Cross and Blue Shield list Winooski Integrative Medicine PC 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 Winooski Integrative Medicine PC was last updated on February 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.
# Winooski Integrative Medicine Pc · NPI 1619694478
Multi-Specialty organization in Winooski, Vermont. Organization record, active in the CMS NPPES registry since October 24, 2022.
## Identity
- **NPI:** 1619694478 (Entity type: Organization)
- **Enumerated:** October 24, 2022
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Sam Russo, PRINCIPAL
## Practice location
- **Address:** 321 MAIN ST STE B, Winooski, VT 05404-1380
- **Phone:** (802) 636-4133
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 14, 2025
- **Other identifiers:** Medicaid 1015129 (VT)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1619694478) · Data from the CMS NPPES public registry.