Active NPI
Samuel Wat, M.D.
- Anesthesiology Physician
- Aurora, IL
National Provider Identifier
1508814419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 036078892
- 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, 2008
- 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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 036078892 | IL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
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- Aurora, IL
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- Muskegon, MI
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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.