Individual provider Active NPI

Sondra Michelle Walter, NP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1952477291
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
303166 Issued in NY
Practice address
177 Fort Washington Ave
New York, NY 10032-3733
Phone
(212) 342-0779
Fax
(212) 342-3591
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 303166 NY Primary
Gerontology Nurse Practitioner 363LG0600X 340459 NY

Addresses

Primary practice location

177 Fort Washington Ave
New York, NY 10032-3733

Mailing address

177 Fort Washington Ave
New York, NY 10032-3733
Phone (212) 342-0779

Other identifiers 1

IdentifierTypeStateIssuer
02196578MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
303166NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Oct 1, 2005 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jan 1, 2019 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jan 1, 2019 Accepting new patients

Locations

630 W 168th St
Fl 12
New York, NY 10032
Phone (212) 305-6262

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

177 Fort Washington Ave
New York, NY 10032
Phone (212) 305-3090

Interoperability endpoints

  • Direct secure messaging: smw9007@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1952477291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323733",
            "telephone_number": "212-342-0779",
            "fax_number": "212-342-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323733",
            "telephone_number": "212-342-0779",
            "fax_number": "212-342-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "SONDRA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "303166",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "340459",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02196578",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.