Individual provider Active NPI

Walter Peter Mutter, M.D.

  • Nephrology Physician
  • Newton, MA
National Provider Identifier
1104895556
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
210130 Issued in MA
Practice address
Newton Wellesley Physicians Nephrology
Newton Wellesley Hospital, Green 460
Newton, MA 20462
Phone
(617) 243-5420
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 210130 MA
Nephrology Physician 207RN0300X 210130 MA Primary

Addresses

Primary practice location

Newton Wellesley Physicians Nephrology
Newton Wellesley Hospital, Green 460
Newton, MA 20462

Mailing address

Newton Wellesley Hospital, Green 460
Newton Wellesley Physicians Nephrology
Newton, MA 20462
Phone (617) 243-5420

Other identifiers 5

IdentifierTypeStateIssuer
J24722OtherMABLUE CROSS BLUE SHEILD
5594198OtherMAFIRST HEALTH
693019OtherMAHARVARD PILGRIM HEALTHCAR
0167100MedicaidMA
210130OtherMATUFTS HEALTH PLAN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070124000225 MA Practitioner - NephrologyPractitioner - Internal Medicine 1254332976 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Massachusetts Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

195 Worcester St
Primary Care of Wellesley
Wellesley, MA 02481-5568
Phone (617) 219-1510

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
The General Hospital Corporation CurrentSince Oct 1, 2015 Accepting new patients
Newton-Wellesley Hospital Current Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Oct 1, 2014 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

800 Washington St
Norwood, MA 02062
Phone (781) 278-6264

Interoperability endpoints

  • Direct secure messaging: mutter.walter.nwh@direct.partners.masshiway.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1104895556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NEWTON WELLESLEY HOSPITAL, GREEN 460",
            "address_2": "NEWTON WELLESLEY PHYSICIANS NEPHROLOGY",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "20462",
            "telephone_number": "617-243-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NEWTON WELLESLEY PHYSICIANS NEPHROLOGY",
            "address_2": "NEWTON WELLESLEY HOSPITAL, GREEN 460",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "20462",
            "telephone_number": "617-243-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTTER",
        "first_name": "WALTER",
        "middle_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "210130",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "210130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "J24722",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "5594198",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "693019",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0167100",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "210130",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.