Stephen Kenton Waterbrook, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A94355 Issued in CA

Practice address

150 Catherine LN
Suite J
Grass Valley, CA 95945-5719

Phone

(530) 272-2257

Fax

(530) 272-6977

NPI assigned

Jun 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

• Stephen K Waterbrook MD Inc

  • Surgery Physician
  • Grass Valley, CA
  • NPI 1215327291
  Authorized official Same address or phone

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1558564872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CATHERINE LN STE J",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455719",
            "telephone_number": "530-269-8191",
            "fax_number": "530-205-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CATHERINE LN",
            "address_2": "SUITE J",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455719",
            "telephone_number": "530-272-2257",
            "fax_number": "530-272-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERBROOK",
        "first_name": "STEPHEN",
        "middle_name": "KENTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A94355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minor E. Ward, M.D.
• Julie A Wardwell
• Alyssa Kathryn Wargala, PA
• Peter Warner, CHIROPRACTOR
• Anna L Wartan, BA
• Veronica Waters
• Dessa June Watson Crabtree
• Sharonda Watson
• Tiffany M Watson
• Chaslynn Watts

• Surgery Physician in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.