Carerivet Medical Services LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CARERIVET MEDICAL SERVICES LLC

Practice address

26 University Place Blvd
1St Floor
Jersey City, NJ 07305

Phone

(845) 721-1848

NPI assigned

Feb 25, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Walters, MD

Title

Owner/MD

Phone

(845) 721-1848

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551052800000",
    "number": "1942767066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 UNIVERSITY PLACE BLVD",
            "address_2": "1ST FLOOR",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 UNIVERSITY PLACE BLVD",
            "address_2": "1ST FLOOR",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07305",
            "telephone_number": "845-721-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARERIVET MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "845-721-1848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "25MA03794100",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; 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.