Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Staples Jr.

Individual provider Family Nurse Practitioner · NPI 1598122947

Charles Staples Jr. is a Nurse Practitioner in Watertown, Connecticut. Qualified in 2015, 11 years ago. Practices with Northeast Medical Group Inc, a 1,360-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
11
Licensed in
CT
In the registry since
2016

Practice location Address checks out

205 Sylvan Lake Rd
Watertown, CT 06779-1450
Phone: (203) 260-8744
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F1015603 (CT)

Record details

NPI number1598122947
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 15, 2016
Last updated in NPPESJanuary 15, 2016
Mailing address205 Sylvan Lake Rd, Watertown, CT 06779-1450

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Northeast Medical Group Inc — 1360 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Watertown