Howard Waitzkin, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

97-162 Issued in NM

Practice address

1399 Weimer Rd
Suite 200
Taos, NM 87571-6340

Phone

(575) 758-2224

Fax

(575) 758-4903

NPI assigned

Jul 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Kewa Pueblo Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Santo Domingo Pueblo, NM
  • NPI 1467739888

  TX

  Medicare reassignment NPD
• Kewa Pueblo Health Corporation

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1336659077
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1770598245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1399 WEIMER RD",
            "address_2": "SUITE 200",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716340",
            "telephone_number": "575-758-2224",
            "fax_number": "575-758-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 WEIMER RD",
            "address_2": "SUITE 200",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716340",
            "telephone_number": "575-758-2224",
            "fax_number": "575-758-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITZKIN",
        "first_name": "HOWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "97-162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Visarraga
• Joann Visarraga
• Lisa Visarraga
• Nikki Vue
• Carl Wagner, D.O.M.
• Wal-Mart Stores East LP
• Walgreen Co
• Mary Elizabeth Wall
• Sherry Renea Wall, RN
• Sarah Waller

• Internal Medicine Physician in Taos, NM
• Providers in Taos, NM by specialty
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.