SAMUEL ROY WALTERS (NPI# 1144368606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144368606 |
| Entity Type | Individual |
| Full Name | SAMUEL ROY WALTERS |
| Credential | M.D. |
| Practice Address |
401 S Van Brunt St Ste 403 Englewood NJ 07631-4635 |
| Practice Telephone | 2014085041 |
| Practice Fax Number | 2014085085 |
| Mailing Telephone | 2014085041 |
| Mailing Fax Number | 2014085085 |
| Enumeration Date | 2007-02-04 |
| Last Update Date | 2020-07-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 115662 | NY | Other Service Providers |
| Y | 207R00000X | Internal Medicine | 25MA03794100 | NJ | Allopathic & Osteopathic Physicians |
| N | 172V00000X | Community Health Worker | 115662 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | MEDICARE EMPIRE | A300031683 | 01 |
| NY | MEDICARE GHI | G300023857 | 01 |
| NY | 00213896 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336119817 | Samuel Walters | Family Medicine | 6531 103rd St, Jacksonville, FL 32210-7131 | 2006-01-25 |
| 1790869782 | Samuel J. Walters | Preventive Medicine | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2006-10-25 |
| Street Address |
401 S VAN BRUNT ST STE 403 |
| City | ENGLEWOOD |
| State | NJ |
| Zip Code | 07631-4635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868922 | Sharmela Brijmohan | Student in an Organized Health Care Education/Training Program | 350 Engle Street Englewood Nj Department of Medicine, Englewood, NJ 07631 | 2020-07-21 |
| 1902422553 | Ross Tyrone Jensen Lavine | Student in an Organized Health Care Education/Training Program | 350 Engle Street, Department of Medicine, Englewood, NJ 07631 | 2020-06-19 |
| 1881235497 | Cbt and Psychodynamic Therapy Associates LLC | Social Worker | 245 Walnut Street, Englewood, NJ 07631 | 2019-10-04 |
| 1346895950 | Eb Care At Englewood, LLC | Assisted Living Facility | 412 South Van Brunt Street, Englewood, NJ 07631 | 2019-08-09 |
| 1730695727 | Maytal Elart | Spec/Tech, Cardiovascular | 151 E Palisades Ave, 16e, Englewood, NJ 07631 | 2017-12-28 |
| 1396259255 | Elizabeth Thottumalil Thomas | Counselor | 93 West Palisade Ave, Englewood, NJ 07631 | 2017-11-29 |
| 1992214381 | Englewood Orthopedics Group PC | Orthopaedic Surgery | 55 Smith St Unit 5653, Englewood, NJ 07631 | 2017-09-28 |
| 1639691579 | Jee Hoon Jang | Student in an Organized Health Care Education/Training Program | 350 Engle St., Englewood, NJ 07631 | 2017-07-12 |
| 1427570332 | Dan Ran Castillo | Student in an Organized Health Care Education/Training Program | 350 Engel Street, Engelwood, NJ 07631 | 2017-07-12 |
| 1275061392 | Thomas J Drexler | Counselor | 93 W. Palisades Ave, Englewood, NJ 07631 | 2017-06-02 |
| Find all providers in zip 07631 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811377146 | Portercare Adventist Health System | Internal Medicine | 10333 E Dry Creek Rd, Suite 100, Englewood, CO 80112-1560 | 2015-06-02 |
| 1649569203 | Avraham J Schreiber, Md Pllc | Internal Medicine | 420 Valley View Rd, Englewood, NJ 07631-1621 | 2011-04-05 |
| 1699072934 | Gulf Coast Hma Physician Management LLC | Internal Medicine | 250 W Dearborn St, Englewood, FL 34223-3245 | 2011-02-23 |
| 1568764389 | Jeanne Day Seibert Md PC | Internal Medicine | 601 E Hampden Ave Ste 160, Englewood, CO 80113-2764 | 2010-11-30 |
| 1669701454 | Vladimir Melamed, M.d, P.c | Internal Medicine | 214 Engle St Ste 11, Englewood, NJ 07631-2418 | 2009-12-08 |
| 1023341047 | Kevin Michael Gershuny | Internal Medicine | 370 Grand Ave Ste 102, Englewood, NJ 07631 | 2009-09-09 |
| 1881822518 | Aron Isaac Schwarcz | Internal Medicine | 25 Rockwood Pl Ste 440, Englewood, NJ 07631-4987 | 2009-07-01 |
| 1033370556 | Marina Vladimirovna Bachurina | Internal Medicine | 501 E. Hampden Ave., Englewood, CO 80113-2702 | 2008-06-18 |
| 1265604565 | Jeffrey Evan Paley | Internal Medicine | 177 N Dean St Ste 203, Englewood, NJ 07631-2523 | 2008-03-26 |
| 1932398534 | R Chunduri Md Inc | Internal Medicine | 1230 Union Blvd, Englewood, OH 45322-2552 | 2007-10-18 |
| Find all providers in ENGLEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.