Amanda Waterman, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

S1949 Issued in TX

Practice address

2529 S 1St St
Austin, TX 78704-5466

Phone

(512) 978-9500

Fax

(512) 901-9708

NPI assigned

Jun 3, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Wayne State University School of Medicine, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Central Texas Community Health CentersGroup PAC ID 5395802151, 165 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Texas Community Health Centers

  • Family Medicine Physician
  • Austin, TX
  • NPI 1427882091
  Medicare reassignment Care Compare group NPD
• Central Texas Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1598591414
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1013397140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2529 S 1ST ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787045466",
            "telephone_number": "512-978-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2529 S 1ST ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787045466",
            "telephone_number": "512-978-9500",
            "fax_number": "512-901-9708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3518 Fm 973",
            "address_purpose": "LOCATION",
            "city": "Del Valle",
            "state": "TX",
            "postal_code": "786173723",
            "country_code": "US",
            "telephone_number": "512-978-9760",
            "fax_number": "512-901-9743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "AMANDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301107689",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S1949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waterloo Family Practice, PLLC
• Waterloo Imaging LLC
• Waterloo Med Co
• Waterloo Medical
• Waterloo Residential Services Inc.
• Alexandria D Waters
• Hunter Waters
• James R. Waters, DDS, MSD
• Kristie Lynn Waters, LMT
• Watershed Group of Austin Dba Lifeologie

• Family Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.