NPIMap

Organization Active NPI

Tristan Medical PC

  • Family Medicine Physician
  • Norton, MA
National Provider Identifier
1154492700
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRISTAN MEDICAL PC
Practice address
184 W Main St Ste 2
Norton, MA 02766-1241
Phone
(508) 824-0243
NPI assigned
Nov 13, 2006
Last updated
Mar 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Julie S. Thibert, DONPI 1467417626
Title
Medical Director
Phone
(508) 824-0243

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X MA
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

184 W Main St Ste 2
Norton, MA 02766-1241

Mailing address

184 W Main St Ste 2
Norton, MA 02766-1241
Phone (508) 824-0243

Other identifiers 2

IdentifierTypeStateIssuer
M18009OtherMAPRACTICE GROUP # BCBS
9749900MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050120000747 MA Part B Supplier - Clinic/Group Practice 9739141037 Receives reassigned benefits from 13 practitioners
Practice locations: Brockton, MA; Norton, MA

National Provider Directory

National Provider Directory

Locations

210 Washington St
Fairhaven, MA 02719
Phone (508) 992-5542

184 W Main St
Ste 2
Norton, MA 02766
Phone (508) 824-0243

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3082/brand/1/csg/22/fhir/r4

Practitioners & affiliated clinicians

Practitioners 37

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 37

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1154492700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 W MAIN ST STE 2",
            "city": "NORTON",
            "state": "MA",
            "postal_code": "027661241",
            "telephone_number": "508-824-0243",
            "fax_number": "774-202-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 W MAIN ST STE 2",
            "city": "NORTON",
            "state": "MA",
            "postal_code": "027661241",
            "telephone_number": "508-824-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAN MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "THIBERT",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "508-824-0243",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE GROUP # BCBS",
            "identifier": "M18009",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9749900",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.