Active NPI
Heidi Wat, M.D.
- Dermatology Physician
- Boston, MA
National Provider Identifier
1891349403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 017377
- Practice address
- 50 Staniford St
Boston, MA 02114-2517 - Phone
- (617) 724-6960
- NPI assigned
- Jul 31, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | A165263 | CA | |
| Dermatology Physician | 207N00000X | 017377 | MA | Primary |
Addresses
Primary practice location
50 Staniford St
Boston, MA 02114-2517
Mailing address
50 Staniford St
Boston, MA 02114-2517
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MUDOCREFERRAL@direct.health.missouri.edu | Direct | Curators of the University of Missouri |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A165263 | CA | MD | Dermatology Physician |
| 017377 | MA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1891349403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 STANIFORD ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 STANIFORD ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142517",
"telephone_number": "617-724-6960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAT",
"first_name": "HEIDI",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-31",
"last_updated": "2022-09-12",
"certification_date": "2022-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "A165263",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MA",
"license": "017377",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
"affiliation": "Y",
"endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
"affiliationName": "Curators of the University of Missouri",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct",
"address_1": "3 Hospital Dr",
"city": "Columbia",
"state": "MO",
"country_code": "US",
"postal_code": "652015276",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.