Individual provider Active NPI

Walter G Stanwood, MD

  • Orthopaedic Surgery Physician
  • Plymouth, MA
National Provider Identifier
1669445243
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
218962 Issued in MA
Practice address
41 Resnik Rd
Plymouth, MA 02360-4842
Phone
(781) 934-2400
Fax
(508) 746-3930
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 218962 MA
Orthopaedic Surgery Physician 207X00000X 218962 MA Primary

Addresses

Primary practice location

41 Resnik Rd
Plymouth, MA 02360-4842

Mailing address

95 Tremont St
Duxbury, MA 02332-4738
Phone (781) 934-2350

Other practice location 1

95 Tremont St
Suite One
Duxbury, MA 02332-4738
Phone (781) 934-2400

Other practice location 2

290 Route 130
Sandwich, MA 02563-2366
Phone (781) 934-2400

Other identifiers 2

IdentifierTypeStateIssuer
P00053230OtherMARAILROAD MEDICARE
2017202MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000045 MA Practitioner - Orthopedic SurgeryPractitioner - Other (Physician) 7113096397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, 1,432 clinicians
Plymouth Bay Orthopedic Associates IncGroup PAC ID 3375448335, 31 clinicians

Practice addresses (Care Compare)

3119 Cranberry Hwy
Suite 5
East Wareham, MA 02538-4840
Phone (508) 759-5411

860 Route 134
Suite 5And6
South Dennis, MA 02660-2577
Phone (508) 385-4212

95 Tremont St
Suite 1
Duxbury, MA 02332-4738
Phone 78193424001204

Hospital & facility affiliations

  • Bayada Home Health Care Inc Home health agency, Plymouth, MA, CCN 227537
  • Vna of Cape Cod Home health agency, South Dennis, MA, CCN 227067
  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060
  • Spaulding Rehabilitation Hospital - Cape Cod Inpatient rehabilitation facility, East Sandwich, MA, CCN 223032

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)70

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218962MAMDSports Medicine (Neuromusculoskeletal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Plymouth Bay Orthopedic Associates Inc. Orthopaedic Surgery CurrentSince Sep 1, 2003 Accepting new patients

Locations

95 Tremont St
Ste 1
Duxbury, MA 02332
Phone (781) 934-2400

41 Resnik Rd
Plymouth, MA 02360
Phone (781) 934-2400

290 Route 130
Sandwich, MA 02563
Phone (508) 833-2255

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 and National Provider Directory roles.

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1669445243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 TREMONT ST",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023324738",
            "telephone_number": "781-934-2350",
            "fax_number": "781-934-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 RESNIK RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604842",
            "telephone_number": "781-934-2400",
            "fax_number": "508-746-3930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Tremont St",
            "address_2": "Suite One",
            "address_purpose": "LOCATION",
            "city": "Duxbury",
            "state": "MA",
            "postal_code": "023324738",
            "country_code": "US",
            "telephone_number": "781-934-2400",
            "fax_number": "508-746-3930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "290 Route 130",
            "address_purpose": "LOCATION",
            "city": "Sandwich",
            "state": "MA",
            "postal_code": "025632366",
            "country_code": "US",
            "telephone_number": "781-934-2400",
            "fax_number": "508-746-3930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANWOOD",
        "first_name": "WALTER",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MA",
            "license": "218962",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "218962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00053230",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017202",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.