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INTERNAL MEDICINE GROUP LLC
NPI 1770617367
Internal Medicine - Geriatric Medicine in Norwich, CT

Active since March 15, 2007CLIA 07D0989083 · Waiver
1 TOWNE PARK PLZ, NORWICH, CT 06360(860) 887-0010(860) 887-0178 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Internal Medicine Group Llc NPPES

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

INTERNAL MEDICINE GROUP LLC (NPI 1770617367) is a healthcare organization registered as a geriatric medicine in Norwich, Connecticut and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through July 16, 2027 and lists Hanna Kackielo, Owner, as its authorized official.

NPPES Registry Identity

NPI1770617367
Entity TypeOrganization
Primary Taxonomy207RG0300X
Legal Business NameINTERNAL MEDICINE GROUP LLC
Location Address1 TOWNE PARK PLZNorwich, CT 06360-2247
Mailing Address1 Towne Park PlzNorwich, CT 06360-2247 · (860) 887-0010 · Fax (860) 887-0178
Phone(860) 887-0010
Fax(860) 887-0178
Organization SubpartNo
Authorized OfficialHanna KackieloOwner · (860) 887-0010
Enumeration DateMarch 15, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1770617367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
License✔ Licensed in CT · 037461
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
1 TOWNE PARK PLZ, Norwich, CT 06360
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

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

Internal Medicine Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Internal Medicine Group LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Hanna Kackielo, MD
Internal Medicine
NPI 1598714701
1 TOWNE PARK PLZ
Norwich, CT 06360
(860) 887-0010
✔ PECOS✔ Accepts MedicareSame address
Jeanne Harrington, AGNP-C
Nurse Practitioner
NPI 1194452599
1 TOWNE PARK PLZ
Norwich, CT 06360
(860) 887-0010
✔ PECOS✔ Accepts Medicare0.1 mi
Elizabeth Devlin, NP
Nurse Practitioner
NPI 1346760253
1 TOWNE PARK PLZ
Norwich, CT 06360
(860) 887-0010
✔ PECOS✔ Accepts Medicare1.9 mi
Brendan Haywood, NP
Nurse Practitioner
NPI 1720806896
1 TOWNE PARK PLZ
Norwich, CT 06360
(860) 887-0010
✔ PECOS✔ Accepts Medicare1.9 mi
Julie Martin, NP
Nurse Practitioner
NPI 1316299704
250 FLAT ROCK PL
Westbrook, CT 06498
(860) 358-3640
✔ PECOS✔ Accepts Medicare25 mi

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 07D0989083

Internal Medicine Group LLC · Norwich, CT
Active · expires Jul 16, 2027
CLIA Number07D0989083
Laboratory TypePhysician Office
Certificate Effective DateJuly 17, 2025
Certificate Expiration DateJuly 16, 2027
Laboratory DirectorHanna Kackielo MD
Laboratory Phone(860) 887-0010
Laboratory LocationInternal Medicine Group LLCOne Towne Park Plaza, Norwich, CT 06360
CLIA data matches this NPI record on: Name Phone
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 Internal Medicine Group LLC's NPI number?

The NPI number for Internal Medicine Group LLC is 1770617367. It was assigned to this organization in the NPPES registry on March 15, 2007.

Where is Internal Medicine Group LLC located?

Internal Medicine Group LLC is located at 1 Towne Park Plz, Norwich, CT 06360. The listed phone number is (860) 887-0010.

What is Internal Medicine Group LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Is Internal Medicine Group LLC enrolled in Medicare?

Yes. Internal Medicine Group LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Internal Medicine Group LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Internal Medicine Group LLC. 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. The largest specialties are Nurse Practitioner (4) and Internal Medicine (1). Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Internal Medicine Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D0989083) is associated with this NPI, valid through July 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Internal Medicine Group LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Internal Medicine 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 Internal Medicine Group LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.