NPIMap

Individual provider Active NPI

Bruce G Watrous, M.D.

  • Cardiovascular Disease Physician
  • Wakefield, MA
National Provider Identifier
1609859958
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
72517 Issued in MA
Practice address
607 North Avenue, Door 17
Wakefield, MA 01880
Phone
(781) 942-0606
Fax
(781) 942-4674
NPI assigned
Nov 21, 2005
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 72517 MA
Cardiovascular Disease Physician 207RC0000X 72517 MA Primary

Addresses

Primary practice location

607 North Avenue, Door 17
Wakefield, MA 01880

Mailing address

607 North Avenue, Door 17
Wakefield, MA 01880
Phone (781) 942-0606

Other practice location 1

60 Hospital Rd
Leominster, MA 01453-2205
Phone (508) 334-3452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060327000540 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4789692179 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Oklahoma College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

60 Hospital Rd
Leominster, MA 01453-2205
Phone (978) 466-2257

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Hallmark Health Medical Associates Inc Internal Medicine CurrentSince Feb 1, 2021 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Melrose Wakefield Cardiac Testing Partnership Internal Medicine PastSince Jun 1, 2008 Accepting new patients

Locations

60 Hospital Rd
Leominster, MA 01453
Phone (978) 466-2000

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

30 New Crossing Rd
Ste 205
Reading, MA 01867
Phone (781) 942-0606

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1609859958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 NORTH AVENUE, DOOR 17",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "01880",
            "telephone_number": "781-942-0606",
            "fax_number": "781-942-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 NORTH AVENUE, DOOR 17",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "01880",
            "telephone_number": "781-942-0606",
            "fax_number": "781-942-4674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Leominster",
            "state": "MA",
            "postal_code": "014532205",
            "country_code": "US",
            "telephone_number": "508-334-3452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATROUS",
        "first_name": "BRUCE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "72517",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "72517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MA

Sources for this page

Verify at the official NPI Registry.