Waters Place Medical Group PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

WATERS PLACE MEDICAL GROUP PC

Practice address

1733 Eastchester Rd
Bronx, NY 10461-2315

Phone

(718) 918-7901

Fax

(718) 918-8364

NPI assigned

Dec 2, 2013

Last updated

Mar 13, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bun Jim, M.D.NPI 1639267834

Title

M.D.

Phone

(718) 918-7901

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bun Jim

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1639267834
  Medicare reassignment Care Compare group NPD Authorized official
• Anjali Acharya

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1003903444
  Medicare reassignment Care Compare group NPD
• Kisra Anis

  • Nephrology Physician
  • Bronx, NY
  • NPI 1518097146
  Medicare reassignment Care Compare group NPD
• Naheed Ansari

  • Nephrology Physician
  • Bronx, NY
  • NPI 1134208374
  Medicare reassignment Care Compare group NPD
• Nidhi Varma, M.D.

  • Nephrology Physician
  • Maumee, OH
  • NPI 1801167143

  NY

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1497186456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 COVERT AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110405437",
            "telephone_number": "917-697-1550",
            "fax_number": "718-918-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612315",
            "telephone_number": "718-918-7901",
            "fax_number": "718-918-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERS PLACE MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-02",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "JIM",
        "authorized_official_first_name": "BUN",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "718-918-7901",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Alan Wastell, R.PH.,M.S.D.C.
• Monica Wat, MD
• Melanie Watanabe, MD
• Oriza Watanabe
• Water Place Pharmacy LLC (Care Pharmacy)
• Nasira Twauna Waters
• Terese Annetta Waters, R.N.
• Isheka Watkins, FNP
• Chely Watson-Badell
• Esther Denise Carline Watson-Douglas

• Nephrology Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.