NPIMap

Individual provider Active NPI

Michael Lee Waters, MD

  • Family Medicine Physician
  • Macomb, IL
National Provider Identifier
1477536993
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
505 E Grant St
Suite 110
Macomb, IL 61455-3352
Phone
(309) 833-1733
Fax
(309) 836-2369
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

505 E Grant St
Suite 110
Macomb, IL 61455-3352

Mailing address

505 E Grant St
Suite 110
Macomb, IL 61455-3352
Phone (309) 833-1733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100604000995 IL Practitioner - Family Practice 9032249883 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McDonough County Hospital District 42 clinicians

Practice addresses (Care Compare)

515 E Grant St
Suite 213
Macomb, IL 61455-3378
Phone (309) 837-6937

525 E Grant St
Macomb, IL 61455-3313
Phone (309) 833-4101

Hospital & facility affiliations

  • MDH Hospice,the Hospice, Macomb, IL, CCN 141524
  • MC Donough District Hospital Hospital, Macomb, IL, CCN 140089
  • Sarah D Culbertson Memorial Hospital Hospital, Rushville, IL, CCN 141333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036098370ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District CurrentSince Dec 1, 2024 Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District CurrentSince Oct 10, 2024 Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District CurrentSince Oct 10, 2024 Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Past Accepting new patients

Locations

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

515 E Grant St
Ste 213
Macomb, IL 61455
Phone (309) 836-1700

515 E Grant St
Ste 112
Macomb, IL 61455
Phone (309) 833-4104

503 E Grant St
Macomb, IL 61455
Phone (309) 833-5917

2 Americinn Way
Ste C
Monmouth, IL 61462
Phone (309) 715-7362

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 3

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477536993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E GRANT ST",
            "address_2": "SUITE 110",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553352",
            "telephone_number": "309-833-1733",
            "fax_number": "309-836-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E GRANT ST",
            "address_2": "SUITE 110",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553352",
            "telephone_number": "309-833-1733",
            "fax_number": "309-836-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, IL

Sources for this page

Verify at the official NPI Registry.