Pieter Joost Van Wattum, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

037137 Issued in CT

Practice address

3 Potter Rd
North Haven, CT 06473-3314

Phone

(203) 985-1555

NPI assigned

Jul 9, 2006

Last updated

Mar 15, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1912930033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 ARMORY ST",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065174005",
            "telephone_number": "203-535-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 POTTER RD",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064733314",
            "telephone_number": "203-985-1555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Armory St",
            "address_purpose": "LOCATION",
            "city": "Hamden",
            "state": "CT",
            "postal_code": "065174005",
            "country_code": "US",
            "telephone_number": "203-535-6473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN WATTUM",
        "first_name": "PIETER JOOST",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "037137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel Gary Umbehr, PA-C
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• Jessica Uzarski, LCSW
• Tracy Van Oss, MPH, OTR/L, CHES
• Ryan Vannieuwenhuyze, DPT
• Varsha Salani DMD, LLC (State of the Art Dentistry)
• Swarupa Rani Vedere
• Lisa Marie Verzella, BCBA
• Vibrant Minds Counseling, LLC

• Child & Adolescent Psychiatry Physician in North Haven, CT
• Providers in North Haven, CT by specialty
• Child & Adolescent Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.

Verify at the official NPI Registry.