Active NPI
Walter Douglas Engle, PAC MPAS
- Physician Assistant
National Provider Identifier
1457407520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1070433
- Practice address
- Heidelberg Meddac
CMR 442
Apo, AE 09042
DE - Phone
- 496221172274
- Fax
- 496221172941
- NPI assigned
- Jan 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1070433 | TX | Primary |
Addresses
Primary practice location
Heidelberg Meddac
CMR 442
Apo, AE 09042
DE
Mailing address
Attn Credentials Office
CMR 442
Apo, AE 09042
DE
Phone 4916221172274
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1070433 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Darmstadt Health Clinic | Past | Accepting new patients | |
| US Army | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Primary Care Clinic/Center
- NPI 1437134822
-
- Military General Acute Care Hospital
- NPI 1669456588
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457407520",
"addresses": [
{
"country_code": "DE",
"country_name": "Germany",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "ATTN CREDENTIALS OFFICE",
"address_2": "CMR 442",
"city": "APO",
"state": "AE",
"postal_code": "09042",
"telephone_number": "4916221172274",
"fax_number": "496221172941"
},
{
"country_code": "DE",
"country_name": "Germany",
"address_purpose": "LOCATION",
"address_type": "FGN",
"address_1": "HEIDELBERG MEDDAC",
"address_2": "CMR 442",
"city": "APO",
"state": "AE",
"postal_code": "09042",
"telephone_number": "496221172274",
"fax_number": "496221172941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGLE",
"first_name": "WALTER",
"middle_name": "DOUGLAS",
"credential": "PAC MPAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "1070433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.