Individual provider Active NPI

Walter J Hooper III, PA-C

  • Physician Assistant
  • Chepachet, RI
National Provider Identifier
1649760067
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01060 Issued in RI
Practice address
712 Putnam Pike Unit 2
Chepachet, RI 02814-1404
Phone
(401) 484-0424
NPI assigned
May 10, 2018
Last updated
Jan 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01060 RI Primary

Addresses

Primary practice location

712 Putnam Pike Unit 2
Chepachet, RI 02814-1404

Mailing address

11 Paris Irons Rd
North Scituate, RI 02857-2838
Phone (401) 484-0424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181128002904 RI Practitioner - Physician Assistant 8325382526 Reassigns benefits to 2 organizations
I20190916002790 MA Practitioner - Physician Assistant 8325382526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tristan Medical Enterprises PCGroup PAC ID 1153503297, 6 clinicians

Practice addresses (Care Compare)

465 S Washington St
North Attleboro, MA 02760-2129
Phone 5083160725104

465 S Washington St
North Attleboro, MA 02760-2159

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean State Urgent Care Center of Woonsocket CurrentSince Jan 8, 2019 Accepting new patients
Newport County Medical Treatment Office Past Accepting new patients

Locations

25 John a Cummings Way
Woonsocket, RI 02895
Phone (401) 235-7310

Interoperability endpoints

  • Direct secure messaging: walter.hooper.1@14269.direct.athenahealth.com

Organizations & group practices 5

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 1

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1649760067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PARIS IRONS RD",
            "city": "NORTH SCITUATE",
            "state": "RI",
            "postal_code": "028572838",
            "telephone_number": "401-484-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 PUTNAM PIKE UNIT 2",
            "city": "CHEPACHET",
            "state": "RI",
            "postal_code": "028141404",
            "telephone_number": "401-484-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOPER",
        "first_name": "WALTER",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chepachet, RI

Sources for this page

Verify at the official NPI Registry.