Individual provider Active NPI

Peter J Waterman, CRNA

  • Certified Registered Nurse Anesthetist
  • Westwood, MA
National Provider Identifier
1144291964
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
229405 Issued in MA
Practice address
690 Canton St
Suite 325
Westwood, MA 02090-2321
Phone
(781) 407-7713
Fax
(781) 407-0998
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 229405 MA Primary

Addresses

Primary practice location

690 Canton St
Suite 325
Westwood, MA 02090-2321

Mailing address

690 Canton St
Suite 325
Westwood, MA 02090-2321
Phone (781) 407-7713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060217000653 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921013590 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Anesthesia PCGroup PAC ID 9638255300, 33 clinicians

Practice addresses (Care Compare)

100 Morse St
Norwood, MA 02062-4679
Phone (781) 255-0362

Hospital & facility affiliations

  • Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
7718CTMDMassage Therapist
229405MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Anesthesia, P.C. CurrentSince Apr 10, 2018 Accepting new patients
Lifespan Physician Group of Massachusetts Inc CurrentSince Jan 1, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Jun 1, 2019 Accepting new patients
Steward Medical Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients

Locations

138 Haverhill St
Andover, MA 01810
Phone (978) 296-2302

70 East St
Methuen, MA 01844
Phone (978) 682-1906

531 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 991-2255

800 Washington St
Norwood, MA 02062
Phone (781) 278-6264

100 Morse St
Norwood, MA 02062
Phone (781) 255-0362

114 Whitwell St
Quincy, MA 02169
Phone (617) 376-4018

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

440 Swansea Mall Dr
Swansea, MA 02777
Phone (508) 324-1171

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1144291964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 CANTON ST",
            "address_2": "SUITE 325",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020902321",
            "telephone_number": "781-407-7713",
            "fax_number": "781-407-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 CANTON ST",
            "address_2": "SUITE 325",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020902321",
            "telephone_number": "781-407-7713",
            "fax_number": "781-407-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "229405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.