NPIMap

Individual provider Active NPI

Jerry Dee Waters, MD

  • Pain Medicine Physician
  • Oroville, CA
National Provider Identifier
1528075454
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
G44051 Issued in CA
Practice address
2721 Olive Hwy
Ste 9
Oroville, CA 95966-6115
Phone
(530) 538-3020
Fax
(530) 533-4243
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X G44051 CA Primary

Addresses

Primary practice location

2721 Olive Hwy
Ste 9
Oroville, CA 95966-6115

Mailing address

236 W East Ave
PMB 323
Chico, CA 95926-7235
Phone (530) 538-3020

Other identifiers 3

IdentifierTypeStateIssuer
P00276055OtherMEDICARE RAILROAD #
00G440510MedicaidCA
P00084218OtherRAILROAD MEDICARE RRM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040401001753 CA Practitioner - Family PracticePractitioner - General Practice 0941292536 Reassigns benefits to 1 organization
Practice locations: Oroville, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oroville HospitalGroup PAC ID 1254234339, shared by 14 NPIs, 93 clinicians

Practice addresses (Care Compare)

2721 Olive Hwy
Oroville, CA 95966-6115
Phone (530) 533-8500

Hospital & facility affiliations

  • Freedom Home Health and Hospice Care Services, Inc Home health agency, Marysville, CA, CCN 059685
  • Butte Home Health and Hospice Home health agency, Chico, CA, CCN 057679
  • Valley View Healthcare Services LLC Home health agency, Chico, CA, CCN 559751
  • Sutter Care at Home Home health agency, Yuba City, CA, CCN 557785
  • Aspire Home Healthcare of Northern California, Inc Home health agency, Yuba City, CA, CCN 059707
  • Oroville Hospital Hospital, Oroville, CA, CCN 050030
  • Enloe Health Hospital, Chico, CA, CCN 050039

Merit-based Incentive Payment System (MIPS)

Final score
77.23 of 100Reported as group
Quality
36.36
Promoting interoperability
100
Improvement activities
40
Cost
71.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G44051CAMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oroville Hospital Past Accepting new patients
Oroville Hospital Past Accepting new patients
Oroville Hospital Past Accepting new patients

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 7

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1528075454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 W EAST AVE",
            "address_2": "PMB 323",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959267235",
            "telephone_number": "530-538-3020",
            "fax_number": "530-533-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 OLIVE HWY",
            "address_2": "STE 9",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666115",
            "telephone_number": "530-538-3020",
            "fax_number": "530-533-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "JERRY",
        "middle_name": "DEE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "G44051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD #",
            "identifier": "P00276055",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G440510",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE RRM",
            "identifier": "P00084218",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oroville, CA

Sources for this page

Verify at the official NPI Registry.