Organization Active NPI

Mitchell J Wachtel DPM PC

  • Podiatrist
  • North Andover, MA
National Provider Identifier
1295918969
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MITCHELL J WACHTEL DPM PC
Practice address
451 Andover St Ste 202
North Andover, MA 01845-5069
Phone
(978) 794-8406
NPI assigned
Dec 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Authorized official

Name
Dr. Mitchell J Wachtel, DPMNPI 1699765503
Title
Owner/President
Phone
(978) 794-8406

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X 001978 MA

Addresses

Primary practice location

451 Andover St Ste 202
North Andover, MA 01845-5069

Mailing address

451 Andover St
Ste 300
North Andover, MA 01845-5044
Phone (978) 794-8406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100726000009 MA Part B Supplier - Clinic/Group Practice 1052443199 Receives reassigned benefits from 1 practitioner
Practice locations: Bradford, MA; Lowell, MA; North Andover, MA
O20100930028636 MA DME Supplier - Physician - Podiatry 1052443199 1 other NPI on this enrollment
Practice locations: North Andover, MA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

451 Andover St
Ste 200
North Andover, MA 01845

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1295918969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 ANDOVER ST",
            "address_2": "STE 300",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455044",
            "telephone_number": "978-794-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 ANDOVER ST STE 202",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455069",
            "telephone_number": "978-794-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL J WACHTEL DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "WACHTEL",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "978-794-8406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "001978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.