Active NPI
James P Pelletier, DPM
- Podiatrist
- Watertown, NY
National Provider Identifier
1508806480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- N0046841
- Practice address
- 21017 Nys Rte 12F
Watertown, NY 13601-4999 - Phone
- (315) 785-3668
- Fax
- (315) 779-2090
- NPI assigned
- Jun 7, 2006
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | N0046841 | NY | Primary |
Addresses
Primary practice location
21017 Nys Rte 12F
Watertown, NY 13601-4999
Mailing address
21017 Nys Rte 12F
Watertown, NY 13601-4999
Phone (315) 785-3668
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01561357 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Temple University School of Podiatric Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
21017 Nys Rte
12F Suite 1
Watertown, NY 13601-1098
Phone (315) 244-2591
Hospital & facility affiliations
- Samaritan Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 237 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1022 |
| Removal or shaving of skin growth | 283 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004684 | NY | MD | Mental Health Counselor |
| N0046841 | NY | MD | Podiatrist |
Organizations & group practices 1
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.
-
- Podiatrist
- Watertown, NY
- NPI 1922046366
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Watertown, NY
- NPI 1598713745
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762214400000",
"number": "1508806480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21017 NYS RTE 12F",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136014999",
"telephone_number": "315-785-3668",
"fax_number": "315-779-2090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21017 NYS RTE 12F",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136014999",
"telephone_number": "315-785-3668",
"fax_number": "315-779-2090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLETIER",
"first_name": "JAMES",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2025-11-04",
"certification_date": "2025-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "N0046841",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01561357",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.