John Felix Waller, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

112971 Issued in NY

Practice address

333 E 56TH St
Ofc 1
New York, NY 10022-3758

Phone

(212) 289-3236

Fax

(212) 289-1880

NPI assigned

Jul 11, 2005

Sex

Male

Sole proprietor

Yes

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1851399216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E 56TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223758",
            "telephone_number": "212-289-3236",
            "fax_number": "212-289-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E 56TH ST",
            "address_2": "OFC 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223758",
            "telephone_number": "212-289-3236",
            "fax_number": "212-289-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "JOHN",
        "middle_name": "FELIX",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "112971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Wallach, MD
• Alison D Wallack, M.S.
• Joel J Wallack, M.D.
• Marc Kenneth Wallack, M.D.
• Anna Waller, PHD
• Leslie A Waller I, LCSW-RP
• Samantha Waller
• Alexa Rose Wallerstein, LMHC
• Avery Wallerstein
• Samson Wallerstein, MS

• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.