Susan E Waters, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G43530 Issued in CA

Practice address

1125 Sir Francis Drake Blvd
Kentfield, CA 94904-1418

Phone

(415) 485-3524

Fax

(415) 485-3507

NPI assigned

Jun 26, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Quantum Healthcare Medical Associates Inc.

  • Hospitalist Physician
  • Colton, CA
  • NPI 1568490597

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1629005772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 SIR FRANCIS DRAKE BLVD",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041418",
            "telephone_number": "415-485-3524",
            "fax_number": "415-485-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 SIR FRANCIS DRAKE BLVD",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041418",
            "telephone_number": "415-485-3524",
            "fax_number": "415-485-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G43530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G435300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Tynan
• Ladan Vakili, DMD
• Aggie Irene Varady, D.M.D.
• Anahi E Vasquez I, MHC
• Jamie Waterman, ATC, EMT
• Vicki L.C. Weatherford, PH.D
• Marc Alan Weiner, D.C.
• Anna West, M.F.T.
• John Paul Whitty II
• Wise Psychology Services, Inc.

• Internal Medicine Physician in Kentfield, CA
• Providers in Kentfield, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.