Individual provider Active NPI

Olga M Waters, RPA-C

  • Physician Assistant
  • Danbury, CT
National Provider Identifier
1598737165
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009678 Issued in NY
Practice address
24 Hospital Ave
Danbury, CT 06810-6099
Phone
(203) 739-7447
Fax
(203) 739-8049
NPI assigned
Feb 7, 2006
Last updated
Sep 6, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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 009678 NY Primary

Addresses

Primary practice location

24 Hospital Ave
Danbury, CT 06810-6099

Mailing address

100 Beach St
Cornwall, NY 12518-1721
Phone (914) 534-4027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009678NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eos Medical Group PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1598737165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BEACH ST",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181721",
            "telephone_number": "914-534-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-739-7447",
            "fax_number": "203-739-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "OLGA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.