DR. DANIEL JOHN WATTENDORF M.D.
NPI 1760496178
Medical Genetics - Clinical Cytogenetics in Keesler Afb, MS
NPI Status: Active since July 28, 2006
Contact Information
301 FISHER ST
RM 1A132
KEESLER AFB, MS
ZIP 39534
Phone: (228) 377-6393
Fax: (228) 377-6304
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- Individual
- Male
- Medical Genetics
- Clinical Cytogenetics
- PECOS Enrolled
About DANIEL WATTENDORF
This page provides the complete NPI Profile along with additional information for Daniel Wattendorf, a provider established in Keesler Afb, Mississippi with a medical specialization in Medical Genetics, focusing in clinical cytogenetics . The healthcare provider is registered in the NPI registry with number 1760496178 assigned on July 2006. The practitioner's primary taxonomy code is 207SC0300X with license number MD067656L (PA). The provider is registered as an individual and his NPI record was last updated September 2025.
- NPI
- 1760496178
- Provider Name
- DR. DANIEL JOHN WATTENDORF M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 301 FISHER ST RM 1A132 KEESLER AFB, MS 39534
- Location Phone
- (228) 377-6393
- Location Fax
- (228) 377-6304
- Mailing Address
- 301 FISHER ST RM 1A132 KEESLER AFB, MS 39534
- Mailing Phone
- (228) 377-6393
- Mailing Fax
- (228) 377-6304
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-28-2006
- Last Update Date
- 09-11-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Medical Genetics Clinical Cytogenetics
- Taxonomy Code
- 207SC0300X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD067656L
- License State
- PA
- Taxonomy Description
- A clinical cytogeneticist demonstrates competence in providing laboratory diagnostic and clinical interpretive services dealing with cellular components, particularly chromosomes, associated with heredity.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | MD067656L (PA) |
| 2 | 207SG0201X | Allopathic & Osteopathic Physicians | Medical Genetics | MD067656L (PA) |
Medicare Participation & PECOS Enrollment Status
Daniel Wattendorf is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Reviews for DR. DANIEL JOHN WATTENDORF M.D.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 6 | 0 | 4 | 9 | 6 | 1 | 7 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 12 | 0 | 8 | 9 | 12 | 1 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 2 + 0 + 8 + 9 + 1 + 2 + 1 + 1 + 4 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1760496178 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1992799241 | MS. ALISON LEIGH BEACH CRNA Individual | Nurse Anesthetist, Certified Registered | 301 FISHER ST BILOXI, MS 39534 (228) 376-6017 |
| 1447219324 | BETSY SMITH MAJMA CRNA Individual | Nurse Anesthetist, Certified Registered | 301 FISHER ST KEESLER AFB, MS 39534 (228) 377-6111 |
| 1629030564 | DR. MICHAEL TODD ACREE PHARMD Individual | Pharmacist | 301 FISHER ST KEESLER AFB, MS 39534 (228) 377-6582 |
| 1316900640 | DONNATA ANTOINE Individual | Pharmacist | 301 FISHER ST BILOXI, MS 39534 (228) 377-8821 |
| 1528021540 | RYAN HOISINGTON PHARMD Individual | Pharmacist | 301 FISHER ST BILOXI, MS 39534 (228) 377-2086 |
| 1275597601 | MRS. PEGGY LEA LEWIS BSN Individual | Registered Nurse (Women's Health Care, Ambulatory) | 301 FISHER ST KAFB BILOXI, MS 39534 (228) 377-6985 |
| 1154386761 | MS. ELIZABETH L BOWERS-KLAINE WCHNP Individual | Nurse Practitioner (Women's Health) | 301 FISHER ST KEESLER AFB, MS 39534 (228) 377-6512 |
| 1609831650 | DR. ROBERT MACK CROMER M.D. Individual | Surgery | 301 FISHER ST GENERAL SURGERY CLINIC KEESLER AFB, MS 39534 (228) 376-0425 |
| 1457319360 | ANN ELIZABETH FARASH M.D. Individual | Pediatrics | 301 FISHER ST ROOM 1A132 BILOXI, MS 39534 (228) 377-8185 |
| 1891743027 | MS. JUDITH L O'NEIL ARNP Individual | Nurse Practitioner (Pediatrics) | 301 FISHER ST BILOXI, MS 39534 (228) 377-8185 |
| 1750317459 | MS. S REBECCA KERSHAW LCSW Individual | Social Worker (Clinical) | 301 FISHER ST KEESLER MEDICAL CENTER BILOXI, MS 39534 (228) 376-3648 |
| 1639109820 | DR. GREGG STEPHEN SILBERG D.O. Individual | Radiology (Diagnostic Radiology) | 301 FISHER ST KEESLER AFB, MS 39534 (228) 376-4823 |
| 1730113374 | DR. VIRGIL SINATRA JEFFERSON M.D. Individual | Military Health Care Provider | 301 FISHER ST BILOXI, MS 39534 (228) 377-6495 |
| 1023043619 | KEESLER MEDICAL CENTER Organization | Military Hospital | 301 FISHER ST BILOXI, MS 39534 (228) 376-3406 |
| 1669574141 | DR. STEVEN M KINDSVATER M.D. Individual | Internal Medicine (Interventional Cardiology) | 301 FISHER ST 81ST MDOS / SGOMC KEESLER AFB, MS 39534 (228) 376-3492 |
| 1386748093 | JOHN PHILLIP HIGHSMITH MD Individual | Family Medicine | 301 FISHER ST KEESLER MEDICAL CENTER KEESLER AFB, MS 39534 (228) 376-0440 |
| 1831286301 | JENNIFER ANN NICHOLSON LCSW Individual | Social Worker (Clinical) | 301 FISHER ST KEESLER AFB, MS 39534 (228) 376-3938 |
| 1982773412 | DR. RAJESH TULI M.D. Individual | Radiology (Diagnostic Radiology) | 301 FISHER ST KEESLER AFB, MS 39534 (210) 543-8278 |
| 1023179827 | MRS. SARAH ELIZABETH MONTOYA-ORTEGA R.D. Individual | Dietitian, Registered | 301 FISHER ST RM-BA 144A BILOXI, MS 39534 (228) 376-5072 |
| 1306991468 | MR. JAMES KEVIN WEBB CRNA Individual | Student in an Organized Health Care Education/Training Program | 301 FISHER ST KEESLER AFB, MS 39534 (228) 377-8431 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760496178, enumerated in the NPI registry as an "individual" on July 28, 2006
The provider is located at 301 Fisher St Rm 1a132 Keesler Afb, Ms 39534 and the phone number is (228) 377-6393
The provider's speciality is Medical Genetics with taxonomy code 207SC0300X with a focus in Clinical Cytogenetics
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on July 28, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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