Waltham Family Practice, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WALTHAM FAMILY PRACTICE, PC

Practice address

9 Hope Ave
1St Floor
Waltham, MA 02453-2741

Phone

(781) 314-0191

Fax

(781) 314-0192

NPI assigned

Aug 9, 2006

Organization subpart

No

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

Authorized official

Name

Punyamurtula S Kishore, MD

Title

President

Phone

(617) 738-4640

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• Direct secure messaging: john.sheena.wmgmd@direct.partners.masshiway.net
• Direct secure messaging: shocair.mawya.wmgmd@direct.partners.masshiway.net

Practitioners 2

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

• Sheena John, M.D.

  • Internal Medicine Physician
  • Wellesley, MA
  • NPI 1396784823
  NPD
• Mawya Shocair, M.D.

  • Nephrology Physician
  • Waltham, MA
  • NPI 1457308140
  NPD

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477563377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 TEMPLE PL",
            "address_2": "STE 612",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111307",
            "telephone_number": "617-264-9764",
            "fax_number": "617-264-9763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HOPE AVE",
            "address_2": "1ST FLOOR",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024532741",
            "telephone_number": "781-314-0191",
            "fax_number": "781-314-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTHAM FAMILY PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KISHORE",
        "authorized_official_first_name": "PUNYAMURTULA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-738-4640",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waltham Diabetes Center, LLC
• Waltham Dialysis LLC
• Waltham Drug LLC
• Waltham Drug LLC
• Waltham Family Dental
• Waltham Modern Dentistry, PC
• Waltham Weston Internal Medicine Associates, P.C.
• CHI Shiang Wang, MD
• Katherine J Wangh, LICSW
• Tyler Wansley

• Family Medicine Physician in Waltham, MA
• Providers in Waltham, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.