INTERNAL MEDICINE GROUP LLC – Geriatric Medicine (Internal Medicine) Physician, NPI 1770617367

INTERNAL MEDICINE GROUP LLC is a healthcare provider. based in Norwich, Connecticut. specializing in Geriatric Medicine (Internal Medicine) Physician. The organization holds a License No. 037461 (CT). The NPI Number for INTERNAL MEDICINE GROUP LLC is 1770617367

Main info

Organization
Name
INTERNAL MEDICINE GROUP LLC
NPI
1770617367
Phone
(860) 887-0010
Address
1 TOWNE PARK PLZ
Authorized Official
DR. HANNA KACKIELO OWNER MD
Enumeration Date
15 March 2007
Last Update Date
22 August 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for INTERNAL MEDICINE GROUP LLC

  • 1 TOWNE PARK PLZ

    NORWICH, CT 063602247

    Phone: (860) 887-0010

    Fax: (860) 887-0178

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-06-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040615001607OClinic/Group PracticeCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06360)

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Reviews

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Frequently asked questions

Does INTERNAL MEDICINE GROUP LLC share an NPI with anyone else?
NPI numbers are unique to each provider or organization — INTERNAL MEDICINE GROUP LLC uses 1770617367.
Is INTERNAL MEDICINE GROUP LLC listed as active for patients and plans?
The listing shows INTERNAL MEDICINE GROUP LLC as active in the NPI system.
What taxonomy line describes INTERNAL MEDICINE GROUP LLC?
For research purposes, treat INTERNAL MEDICINE GROUP LLC as Geriatric Medicine (Internal Medicine) Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does INTERNAL MEDICINE GROUP LLC serve?
INTERNAL MEDICINE GROUP LLC's listing highlights Norwich, Connecticut; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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