Active NPI
Diana Trister, D.O
- Sports Medicine (Family Medicine) Physician
- Northborough, MA
National Provider Identifier
1609004464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 254413
- Practice address
- 290 W Main St Ste 6
Northborough, MA 01532-2164 - Phone
- (508) 501-7017
- Fax
- (508) 526-9982
- NPI assigned
- Jun 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 254413 | MA | Primary |
Addresses
Primary practice location
290 W Main St Ste 6
Northborough, MA 01532-2164
Mailing address
290 W Main St Ste 6
Northborough, MA 01532-2164
Phone (508) 501-7017
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130918000315 | MA | Practitioner - Family Practice | 1951545789 | Practice locations: Northborough, MA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 254413 | MA | MD | Sports Medicine (Family Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762214400000",
"number": "1609004464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 W MAIN ST STE 6",
"city": "NORTHBOROUGH",
"state": "MA",
"postal_code": "015322164",
"telephone_number": "508-501-7017",
"fax_number": "508-526-9982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 W MAIN ST STE 6",
"city": "NORTHBOROUGH",
"state": "MA",
"postal_code": "015322164",
"telephone_number": "508-501-7017",
"fax_number": "508-526-9982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRISTER",
"first_name": "DIANA",
"name_prefix": "Dr.",
"credential": "D.O",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-30",
"last_updated": "2025-11-04",
"certification_date": "2025-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Sports Medicine",
"state": "MA",
"license": "254413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.