Organization Active NPI

Joe Walters MD Inc. a Medical Corporation

  • Primary Care Clinic/Center
  • Saratoga, CA
National Provider Identifier
1336367234
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
G84144 Issued in CA
Legal business name
JOE WALTERS MD INC. A MEDICAL CORPORATION
Practice address
12961 Village Drive
Suite 1
Saratoga, CA 95070-4158
Phone
(408) 253-4806
Fax
(408) 257-9701
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Authorized official

Name
Dr. Joseph John Walters, M.D.NPI 1144326752
Title
President
Phone
(408) 253-4806

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X G84144 CA Primary

Addresses

Primary practice location

12961 Village Drive
Suite 1
Saratoga, CA 95070-4158

Mailing address

12961 Village Drive
Suite a
Saratoga, CA 95070-4158
Phone (408) 253-4806

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081013000154 CA Part B Supplier - Clinic/Group Practice 6002984465 Receives reassigned benefits from 1 practitioner
Practice locations: Los Gatos, CA; San Jose, CA; Saratoga, CA

National Provider Directory

National Provider Directory

Locations

12961 Village Dr
Ste 1
Saratoga, CA 95070
Phone (408) 253-4806

Practitioners & affiliated clinicians

Practitioners 2

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": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1336367234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12961 VILLAGE DRIVE",
            "address_2": "SUITE A",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704158",
            "telephone_number": "408-253-4806",
            "fax_number": "408-257-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12961 VILLAGE DRIVE",
            "address_2": "SUITE 1",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704158",
            "telephone_number": "408-253-4806",
            "fax_number": "408-257-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOE WALTERS MD INC. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-253-4806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "G84144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.