Individual provider Active NPI

Walter Reginald Rogers Sr., M.D.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1790020345
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
281500-1 Issued in NY
Practice address
1046 E 82ND St
Apartment 1
Brooklyn, NY 11236-4224
Phone
(347) 673-8825
NPI assigned
Dec 10, 2012
Last updated
Dec 7, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 281500-1 NY Primary

Addresses

Primary practice location

1046 E 82ND St
Apartment 1
Brooklyn, NY 11236-4224

Mailing address

1046 E 82ND St
Apartment 1
Brooklyn, NY 11236-4224
Phone (347) 673-8825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160223002344 NY Practitioner - Family Practice 8628298148 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctor's Medical PCGroup PAC ID 7416005103, 15 clinicians
Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians
Urgent Care Physician of New York-Hartsdale PLLCGroup PAC ID 8628253697, 13 clinicians

Practice addresses (Care Compare)

2968 Ave X
Brooklyn, NY 11235-1808
Phone (718) 769-4988

3379 Crompond Rd
Yorktown Heights, NY 10598-3605
Phone (914) 930-5550

42 Rockland PLZ
Suite 22
Nanuet, NY 10954-2208
Phone (845) 367-7395

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SBH Physicians, PC CurrentSince Feb 3, 2021 Accepting new patients
Divinity Medical Services PLLC CurrentSince Nov 1, 2022 Accepting new patients
TBHC Medical Services PC Family Medicine CurrentSince Oct 8, 2020 Accepting new patients
SBH Physicians, PC Family Medicine CurrentSince Feb 3, 2021 Accepting new patients
Urgent Care Physician of New York-Hartsdale PLLC CurrentSince Apr 19, 2024 Accepting new patients

Locations

21304 Northern Blvd
Bayside, NY 11361
Phone (929) 744-1197

111 E 210th St
Bronx, NY 10467

332 E 149th St
Bronx, NY 10451
Phone (347) 329-4010

4507 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

514 Fulton St
Brooklyn, NY 11201
Phone (718) 940-5000

514 Fulton St
Brooklyn, NY 11201

42 Rockland Plz
Ste 22
Nanuet, NY 10954
Phone (845) 367-7395

3379 Crompond Rd
Yorktown Hts, NY 10598
Phone (914) 245-1111

Interoperability endpoints

  • Direct secure messaging: wrogers17765@prd.direct.tbh.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1790020345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 E 82ND ST",
            "address_2": "APARTMENT 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364224",
            "telephone_number": "347-673-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 E 82ND ST",
            "address_2": "APARTMENT 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364224",
            "telephone_number": "347-673-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "WALTER",
        "middle_name": "REGINALD",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-10",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "281500-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.