Paul D Barter, FNP
Individual provider Active NPI Family Nurse Practitioner · Watertown, NY
NPI 1679550552 · NPPES record last updated Nov 22, 2016
Key facts
- NPI
- 1679550552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F3314201 (NY)
- Practice address
- 428 Washington St
Ste 4
Watertown, NY 13601-4832 - Phone
- (315) 788-4880
- Fax
- (315) 788-4896
- NPI assigned
- Dec 30, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100812000832 | NY | Practitioner - Nurse Practitioner | 0941228720 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 331420 | NY | MD | Licensed Practical Nurse |
| F3314201 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Country Family Medicine PLLC | Current |
Accepting new patients | |
| James E. Willis MD PC | Past |
Accepting new patients |
Locations
428 Washington St
Ste 4
Watertown, NY 13601
Phone (315) 788-0202
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F3314201 | NY | Yes |
Addresses
Primary practice location
428 Washington St
Ste 4
Watertown, NY 13601-4832
Mailing address
428 Washington St
Ste 4
Watertown, NY 13601-4832
Phone (315) 788-4880
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01777691 | Medicaid | NY |
Other providers in Watertown, NY
- Everett Darryl Barnes
- Brandy Barniak
- John Patrick Barrett
- Joseph Edward Barron
- Jennifer Rose Barse
- Michelle Ann Bartlett
- Yvonne Victoria Bates
- Alivia Battisti
- Nicole Baughn
- Steven Edwin Beach Jr.
All providers in Watertown, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.