Peter J Walter, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

195224 Issued in NY

Practice address

117 Foote Ave
Suite 100
Jamestown, NY 14701-6947

Phone

(716) 338-9200

Fax

(716) 338-9250

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Western New York Urology Associates, LLC

  • Urology Physician
  • Jamestown, NY
  • NPI 1639209067
  NPD (past) Authorized official

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1992735377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 FOOTE AVE",
            "address_2": "SUITE 100",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016947",
            "telephone_number": "716-338-9200",
            "fax_number": "716-338-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 FOOTE AVE",
            "address_2": "SUITE 100",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016947",
            "telephone_number": "716-338-9200",
            "fax_number": "716-338-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "195224",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD052611L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518827",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodney Michael Waite, DDS
• Rachel Elaine Waldron
• Walgreen Co
• Marilyn Wallin
• Lisa A Walter, N.P.
• Ling Jie Wang, M.D.
• Nana Wang, PHARMD
• Andrew Ward
• Anthony L Ward, DPT
• Jennifer Ware

• Urology Physician in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Urology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.