GEORGE H WATHEN MD PA
NPI 1710168836
Specialist in Waldorf, MD
About George H Wathen Md Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GEORGE H WATHEN MD PA (NPI 1710168836) is a healthcare organization registered as a specialist in Waldorf, Maryland and active in the NPI registry since November 2007. The organization holds a CLIA Microscopy certificate valid through June 28, 2028 and lists George H Wathen, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
George H Wathen Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to George H Wathen MD PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 21D1010496
George H Wathen MD Facp · Waldorf, MDFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is George H Wathen MD PA's NPI number?
The NPI number for George H Wathen MD PA is 1710168836. It was assigned to this organization in the NPPES registry on November 16, 2007.
Where is George H Wathen MD PA located?
George H Wathen MD PA is located at Suite 103 11345 Pembrooke Sq, Waldorf, MD 20603. The listed phone number is (301) 645-8144.
What is George H Wathen MD PA's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is George H Wathen MD PA enrolled in Medicare?
Yes. George H Wathen MD PA is registered in the Medicare PECOS enrollment system.
When is George H Wathen MD PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Maryland, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through George H Wathen MD PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to George H Wathen MD PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does George H Wathen MD PA hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 21D1010496) is associated with this NPI, valid through June 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for George H Wathen MD PA was last updated on February 15, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# George H Wathen Md Pa · NPI 1710168836
Specialist organization in Waldorf, Maryland. Organization record, active in the CMS NPPES registry since November 16, 2007.
## Identity
- **NPI:** 1710168836 (Entity type: Organization)
- **Enumerated:** November 16, 2007
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** George Wathen, PRESIDENT
## Practice location
- **Address:** SUITE 103, 11345 PEMBROOKE SQ, Waldorf, MD 20603-4804
- **Phone:** (301) 645-8144 · **Fax:** (301) 870-8392
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Maryland, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 15, 2008
- **Other identifiers:** Other DG5923; Medicare PIN G02195 (DC); Medicare PIN 223N239G (MD); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1710168836) · Data from the CMS NPPES public registry.