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PEDIATRIC WELLNESS OF NORTHERN NEW YORK
NPI 1982389854
Pediatrics in Watertown, NY

Active since June 19, 2023CLIA 33D0672849 · Waiver
1571 WASHINGTON ST, SUITE 107, WATERTOWN, NY 13601(315) 782-7330(315) 782-5773 Get Directions Write a Review

NPPES record last updated: March 14, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pediatric Wellness Of Northern New York NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC WELLNESS OF NORTHERN NEW YORK (NPI 1982389854) is a healthcare organization registered as a pediatrics in Watertown, New York and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through May 21, 2027 and lists Myla D Estepa, Owner, as its authorized official.

NPPES Registry Identity

NPI1982389854
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePEDIATRIC WELLNESS OF NORTHERN NEW YORK
Location Address1571 WASHINGTON ST, SUITE 107Watertown, NY 13601
Mailing Address1571 Washington St, Suite 107Watertown, NY 13601 · (315) 782-7330 · Fax (315) 782-5773
Phone(315) 782-7330
Fax(315) 782-5773
Organization SubpartNo
Authorized OfficialMyla D EstepaOwner · (315) 782-7330
Enumeration DateJune 19, 2023
Last NPPES UpdateMarch 14, 2024
NPPES CertifiedJune 19, 2023
✔ NPI 1982389854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1571 WASHINGTON ST, Watertown, NY 13601
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 of Waiver 33D0672849

Pediatrics Wellness Of Northern New York · Watertown, NY
Active · expires May 21, 2027
CLIA Number33D0672849
Laboratory TypePhysician Office
Certificate Effective DateMay 22, 2025
Certificate Expiration DateMay 21, 2027
Laboratory DirectorDr. Myla D. Estepa
Laboratory Phone(315) 782-7330
Laboratory LocationPediatrics Wellness Of Northern New York19474 Howell Dr, Watertown, NY 13601
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLISON VESPA P.T.
Physical Therapist
1571 WASHINGTON ST, SUITE 201
WATERTOWN, NY 13601
Jefferson County (315) 782-1650
KAREN LOUISE FISH MPAS, PA-C
Physician Assistant (Surgical)
1571 WASHINGTON ST, SUITE 201
WATERTOWN, NY 13601
Jefferson County (315) 836-2167
DR. SUSANNE DAYE MD
Radiology (Diagnostic Radiology)
1571 WASHINGTON ST, SUITE 101
WATERTOWN, NY 13601
Jefferson County (315) 786-5046
DR. STEVEN B FISH M.D.
Orthopaedic Surgery
1571 WASHINGTON ST, SUITE 201
WATERTOWN, NY 13601
Jefferson County (315) 782-1650
DR. LEO J GOSSELIN JR. M.D.
Surgery
1571 WASHINGTON ST, SUITE 201
WATERTOWN, NY 13601
Jefferson County (315) 782-1650
DR. TODD D CLOPPER MD
Radiology (Vascular & Interventional Radiology)
1571 WASHINGTON ST
WATERTOWN, NY 13601
Jefferson County (315) 786-5000
DANIEL J WEBER MD
Radiology (Diagnostic Radiology)
1571 WASHINGTON ST, SUITE 101
WATERTOWN, NY 13601
Jefferson County (315) 786-5046
BARRATT MATTHEW SCHULTZ MPAS, PA-C
Physician Assistant
1571 WASHINGTON ST, SUITE 201
WATERTOWN, NY 13601
Jefferson County (315) 782-1650

Frequently 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 Pediatric Wellness Of Northern New York's NPI number?

The NPI number for Pediatric Wellness Of Northern New York is 1982389854. It was assigned to this organization in the NPPES registry on June 19, 2023.

Where is Pediatric Wellness Of Northern New York located?

Pediatric Wellness Of Northern New York is located at 1571 Washington St Suite 107, Watertown, NY 13601. The listed phone number is (315) 782-7330.

What is Pediatric Wellness Of Northern New York's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Pediatric Wellness Of Northern New York hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0672849) is associated with this NPI, valid through May 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pediatric Wellness Of Northern New York was last updated on March 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.