Walden Medical, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

117499 Issued in NY

Legal business name

WALDEN MEDICAL, PLLC

Practice address

142 South Montgomery St
Walden, NY 12586

Phone

(845) 778-5811

Fax

(845) 778-5564

NPI assigned

Sep 7, 2007

Last updated

Sep 7, 2007By 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

Franklin P Guneratne, M.D.NPI 1649352048

Title

Owner

Phone

(845) 778-5811

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 3

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.

• Franklin P Guneratne, M.D.

  • Internal Medicine Physician
  • Walden, NY
  • NPI 1649352048
  Medicare reassignment NPD Authorized official
• Heather Wilantewicz, RPA-C

  • Medical Physician Assistant
  • Walden, NY
  • NPI 1467583906
  Medicare reassignment
• Robin Desrosiers, NP

  • Nurse Practitioner
  • Walden, NY
  • NPI 1295866523
  NPD (past)

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1568657005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 SOUTH MONTGOMERY ST",
            "city": "WALDEN",
            "state": "NY",
            "postal_code": "12586",
            "telephone_number": "845-778-5811",
            "fax_number": "845-778-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 SOUTH MONTGOMERY ST",
            "city": "WALDEN",
            "state": "NY",
            "postal_code": "12586",
            "telephone_number": "845-778-5811",
            "fax_number": "845-778-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDEN MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "GUNERATNE",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-778-5811",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007210",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "304569",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "117499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00373744",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie L Vesely, LMT
• Carmelina Ann Vivenzio
• Catherine M Wagner, D.C.
• Walden Ambulance Corp
• Walden Counseling Center
• Walden Pharmacy LLC (The Medicine Shoppe)
• Catherine Grace Walker, MS, CCC-SLP
• Michael Lee Warren, CASAC
• Maureen Wassermann
• Rocky Lee Watkins

• Internal Medicine Physician in Walden, NY
• Providers in Walden, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.