NPIMap

Organization Active NPI

Worcester Internal Medicine, Inc.

  • Internal Medicine Physician
  • Worcester, MA
National Provider Identifier
1063565422
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40759 Issued in MA
Legal business name
WORCESTER INTERNAL MEDICINE, INC.
Practice address
416 Belmont St
Worcester, MA 01604-1086
Phone
(508) 756-1808
Fax
(508) 798-0538
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Thomas R Patnaude, M.D.NPI 1316994049
Title
Owner
Phone
(508) 756-1808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 40759 MA Primary

Addresses

Primary practice location

416 Belmont St
Worcester, MA 01604-1086

Mailing address

416 Belmont St
Worcester, MA 01604-1086
Phone (508) 756-1808

Other identifiers 3

IdentifierTypeStateIssuer
722326OtherMATUFTS
7810OtherMAFALLON COMM. HEALTH PLAN
9726993MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040802000222 MA Part B Supplier - Clinic/Group Practice 8022089440 Receives reassigned benefits from 28 practitioners
Practice locations: Worcester, MA

National Provider Directory

National Provider Directory

Locations

416 Belmont St
Worcester, MA 01604
Phone (508) 756-1808

416 Belmont St
Ste 1
Worcester, MA 01604
Phone (508) 756-6609

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGFCDD

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1063565422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041086",
            "telephone_number": "508-756-1808",
            "fax_number": "508-798-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041086",
            "telephone_number": "508-756-1808",
            "fax_number": "508-798-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WORCESTER INTERNAL MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "PATNAUDE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-756-1808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "40759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "722326",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMM. HEALTH PLAN",
            "identifier": "7810",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9726993",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.