Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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

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

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

Active since June 19, 2023CLIA 33D0672849 · Waiver

19474 HOWELL DR, WATERTOWN, NY 13601(315) 782-7330(315) 782-5773 Get Directions Write a Review

NPPES record last updated: August 31, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 31, 2026, Jun 19, 2023 (2 updates tracked since 2023).

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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 Reynaldo Estepa, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1982389854

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NamePEDIATRIC WELLNESS OF NORTHERN NEW YORK

Location Address19474 HOWELL DRWatertown, NY 13601-6459

Mailing Address19474 Howell DrWatertown, NY 13601-6459 · (315) 782-7330 · Fax (315) 782-5773

Phone(315) 782-7330

Fax(315) 782-5773

Organization SubpartNo

Authorized OfficialReynaldo EstepaOffice Manager · (315) 782-7330

Enumeration DateJune 19, 2023

Last NPPES UpdateAugust 31, 20262 updates tracked since enumeration

NPPES CertifiedAugust 31, 2026

✔ 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.

19474 HOWELL DR, 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: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

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 19474 Howell Dr, 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 August 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days 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.