Individual provider Active NPI

Kara Waterman

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1013549435
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0007966 Issued in CO
Practice address
300 S Jackson St
Denver, CO 80209-3176
Phone
(720) 724-3668
NPI assigned
Feb 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0007966 CO Primary

Addresses

Primary practice location

300 S Jackson St
Denver, CO 80209-3176

Mailing address

300 S Jackson St
Denver, CO 80209-3176
Phone (703) 347-3952

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210513001007 IL Practitioner - Physician Assistant 9931518412 Reassigns benefits to 2 organizations
I20230727003090 CO Practitioner - Physician Assistant 9931518412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denver Wellness AssociatesGroup PAC ID 3274949730, 50 clinicians

Practice addresses (Care Compare)

400 S Colorado Blvd
Suite 600
Denver, CO 80246-1239
Phone (720) 724-3668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inner-City Muslim Action Network CurrentSince Feb 19, 2021 Accepting new patients
Denver Wellness Associates PastSince Sep 10, 2023 Accepting new patients
Denver Wellness Associates PastSince Aug 25, 2024 Accepting new patients
Denver Wellness Associates PastSince Dec 5, 2021 Accepting new patients

Locations

2744 W 63rd St
Chicago, IL 60629
Phone (773) 434-4626

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1013549435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093176",
            "telephone_number": "703-347-3952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093176",
            "telephone_number": "720-724-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "KARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.