Clarence L Waltrous Jr., M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

134427 Issued in NY

Practice address

63 Pennsylvania Ave
Brooklyn, NY 11207-2405

Phone

(646) 317-0720

NPI assigned

Jul 28, 2006

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

Other identifiers 3

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

Specialty

NephrologyAlso: Internal Medicine

Education

Howard University College of Medicine, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Linden Medical Group, PLLCGroup PAC ID 0749721512, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rogosin Brooklyn East Dialysis Dialysis facility, Brooklyn, NY, CCN 332535

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Linden Medical Group, PLLC

  • Nephrology Physician
  • Brooklyn, NY
  • NPI 1669218517
  Medicare reassignment Care Compare group NPD
• Heights Dermatology and Laser Group PC

  • Specialist
  • Brooklyn, NY
  • NPI 1013058890
  NPD (past)
• Westbury Medical Group PC

  • Nephrology Physician
  • Brooklyn, NY
  • NPI 1629264114
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Rogosin Institute Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brooklyn, NY
  • NPI 1982941290

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1942214580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 DUNCAN DR",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901404",
            "telephone_number": "646-317-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072405",
            "telephone_number": "646-317-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTROUS",
        "first_name": "CLARENCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "134427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTHCARE, AETNA",
            "identifier": "2488517",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01535928",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2119500",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gladys Walton, LPN
• Lorna Agatha Walton, RPA-C
• Pattie N Walton, FNP
• Susan Elizabeth Walton, LCAT
• Vanessa Walton, LMSW
• Leone L Waltrous
• David M Waltuch, D.D.S.
• Margo Alayne Waltz
• Rachel Ehg Waltz
• Heba Waly, DPT

• Nephrology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.