Individual provider Active NPI

Samuel Wat, M.D.

  • Anesthesiology Physician
  • Aurora, IL
National Provider Identifier
1508814419
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036078892 Issued in IL
Practice address
2000 Ogden Ave
Rush Copley Memorial Hospital
Aurora, IL 60504-7222
Phone
(630) 978-6200
NPI assigned
May 4, 2006
Last updated
Aug 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036078892 IL Primary

Addresses

Primary practice location

2000 Ogden Ave
Rush Copley Memorial Hospital
Aurora, IL 60504-7222

Mailing address

185 Penny Ave
Suite D
East Dundee, IL 60118-1454
Phone (847) 836-7015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036078892ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Anesthesia PLLC Anesthesiology Past Accepting new patients
Atp Anesthesia LLC Anesthesiology 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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1508814419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 PENNY AVE",
            "address_2": "SUITE D",
            "city": "EAST DUNDEE",
            "state": "IL",
            "postal_code": "601181454",
            "telephone_number": "847-836-7015",
            "fax_number": "847-428-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OGDEN AVE",
            "address_2": "RUSH COPLEY MEMORIAL HOSPITAL",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047222",
            "telephone_number": "630-978-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAT",
        "first_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036078892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.