Individual provider Active NPI

Michele Marie Walters, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1396817300
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
221338 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 278-0702
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 221338 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

47 Joy St
Apartment 4
Boston, MA 02114-4042
Phone (617) 523-1076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081222000207 MA Practitioner - Diagnostic Radiology 3577625805 Reassigns benefits to 2 organizations
I20220713000186 NY Practitioner - Diagnostic Radiology 3577625805 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Connecticut School of Medicine, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Children'S Hospital Radiology Foundation, Inc.Group PAC ID 6901800861, 58 clinicians

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5724

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221338MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Health Imaging Partners, LLC Diagnostic Radiology CurrentSince Jul 19, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Sep 10, 2023 Accepting new patients
Children'S Hospital Radiology Foundation, Inc. Diagnostic Radiology CurrentSince Jan 26, 2010 Accepting new patients
Zwanger & Pesiri Radiology Group, LLP Diagnostic Radiology CurrentSince Apr 1, 2022 Accepting new patients
Montefiore Medical Center Diagnostic Radiology CurrentSince Sep 10, 2023 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

300 Longwood Ave
#B
Boston, MA 02115

75 Francis St
Boston, MA 02115

111 E 210th St
Bronx, NY 10467

23135 Merrick Blvd
Laurelton, NY 11413
Phone (718) 481-8693

150 Sunrise Hwy
Ste E
Lindenhurst, NY 11757

150 Sunrise Hwy
Lindenhurst, NY 11757
Phone (631) 957-3355

150 Sunrise Hwy
Ste 201
Lindenhurst, NY 11757

126 Hicksville Rd
Massapequa, NY 11758
Phone (516) 798-3614

100 Corporate Dr
Ste 100
Yonkers, NY 10701
Phone (914) 378-6148

Interoperability endpoints

  • Direct secure messaging: mwalters26490@direct.bostonchildrens.org

Organizations & group practices 5

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 1

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396817300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 JOY ST",
            "address_2": "APARTMENT 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144042",
            "telephone_number": "617-523-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-278-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MICHELE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "221338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.