Walter August Minaert Jr., MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

1227821 Issued in NY

Practice address

21017 State Route 12F
Watertown, NY 13601-1078

Phone

(315) 782-1990

Fax

(315) 782-1037

NPI assigned

Jun 26, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• North Country Physicians, PLLC

  • Surgery Physician
  • Watertown, NY
  • NPI 1528150737
  Authorized official Same address or phone
• Walter a. Minaert, MD PC

  • Surgery Physician
  • Watertown, NY
  • NPI 1619124724
  Authorized official Same address or phone

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1851328025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21017 STATE ROUTE 12F",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011078",
            "telephone_number": "315-782-1990",
            "fax_number": "315-782-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21017 STATE ROUTE 12F",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011078",
            "telephone_number": "315-782-1990",
            "fax_number": "315-782-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINAERT",
        "first_name": "WALTER",
        "middle_name": "AUGUST",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "1227821",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "122792",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00585011",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Miller
• Jeffrey Miller, PHARMD
• Shaelynn Marie Miller, LPN
• Kelly Mills
• Marcy B Mills, NP
• Rebecca J Minckler, MA/CAS
• Eve Rosemary Mingle, RDN,CDN
• Ruth Amalea Mintz, MS, RD
• Conor Miro
• Mlmhhc Services LLC

• Surgery Physician in Watertown, NY
• Providers in Watertown, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.