Individual provider Active NPI

Thomas H Walter, DPM

  • Podiatrist
  • Pawcatuck, CT
National Provider Identifier
1457317190
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
P00337 Issued in CT
Practice address
145 Liberty St
Pawcatuck, CT 06379-1538
Phone
(860) 599-4555
Fax
(860) 599-1394
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X P00337 CT Primary
Podiatrist 213E00000X DPM00211 RI

Addresses

Primary practice location

145 Liberty St
Pawcatuck, CT 06379-1538

Mailing address

145 Liberty St
Pawcatuck, CT 06379-1538
Phone (860) 599-4555

Other identifiers 2

IdentifierTypeStateIssuer
4061347MedicaidCT
059393001OtherCTDMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080911000394 CT Practitioner - Podiatry 6901972132 Reassigns benefits to 1 organization
Practice locations: Storrs Mansfield, CT; Pawcatuck, CT; Groton, CT; Norwich, CT; Mystic, CT; New London, CT; Gales Ferry, CT; Griswold, CT

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1978
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

380 Salem Tpke
Bozrah, CT 06334-1539
Phone (860) 861-9704

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue25
Removal of skin lesions1-10
Removal of nail tissue388
Removal or shaving of skin growth56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DPM00211RIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Matters LLC PastSince Dec 8, 2024 Accepting new patients
Orthopedic Surgeons LTD Podiatrist Past Accepting new patients
Vna East,Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: thomas.walter.1@12934.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1457317190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 LIBERTY ST",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791538",
            "telephone_number": "860-599-4555",
            "fax_number": "860-599-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 LIBERTY ST",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791538",
            "telephone_number": "860-599-4555",
            "fax_number": "860-599-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "THOMAS",
        "middle_name": "H",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "P00337",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "RI",
            "license": "DPM00211",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4061347",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "059393001",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawcatuck, CT

Sources for this page

Verify at the official NPI Registry.