Individual provider Active NPI

Michael Farris Waters, MD

  • Neurology Physician
  • New York, NY
National Provider Identifier
1629140561
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
327113 Issued in NY
Practice address
1 Gustave L Levy PL FL 12
New York, NY 10029-6574
Phone
(212) 241-7076
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X 52108 AZ
Vascular Neurology Physician 2084V0102X 327113 NY
Neurology Physician 2084N0400X 327113 NY Primary
Specialist 174400000X A78335 CA
Neurology Physician 2084N0400X ME86883 FL
Neurology Physician 2084N0400X 52108 AZ

Addresses

Primary practice location

1 Gustave L Levy PL FL 12
New York, NY 10029-6574

Mailing address

2910 N 3Rd Ave # 470
Phoenix, AZ 85013-4434
Phone (602) 406-6262

Other practice location 1

240 W Thomas Rd # 403
Phoenix, AZ 85013
Phone (602) 406-6262

Other practice location 2

2910 N 3rd Ave # 470
Phoenix, AZ 85013-4434
Phone (602) 406-6262

Other practice location 3

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 273-5550

Other identifiers 1

IdentifierTypeStateIssuer
279658900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AZ, TX, NY4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20071207000168 FL Practitioner - Neurology 8729015995 Reassigns benefits to 1 organization
I20160916002133 AZ Practitioner - Neurology 8729015995 Reassigns benefits to 1 organization
I20170927003846 TX Practitioner - Neurology 8729015995 Reassigns benefits to 1 organization
I20240118001080 NY Practitioner - Neurology 8729015995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Florida College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Gustave Levy Place
Mount Sinai Emergency Room
New York, NY 10029-6500
Phone (212) 241-4572

5 E 98TH St 2ND FL
New York, NY 10029-6501
Phone (212) 241-4572

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME86883FLMDNeurology Physician
327113NYMDNeurology Physician
52108AZMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation CurrentSince Aug 25, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 9, 2023 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Aug 25, 2017 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Nov 15, 2007 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 9, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Nov 15, 2007 Accepting new patients
St. Joseph's Hospital and Medical Center CurrentSince Sep 22, 2017 Accepting new patients
Livi Medical Services LLC PastSince Aug 26, 2024 Accepting new patients
Mount Sinai Hospital Past Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

File 56765
Los Angeles, CA 90074

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1 Gustave L Levy Pl
Fl 12
New York, NY 10029
Phone (212) 241-1518

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 9

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1629140561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 N 3RD AVE # 470",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134434",
            "telephone_number": "602-406-6262",
            "fax_number": "602-406-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-241-7076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 W Thomas Rd # 403",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "85013",
            "country_code": "US",
            "telephone_number": "602-406-6262",
            "fax_number": "602-406-6261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2910 N 3rd Ave # 470",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850134434",
            "country_code": "US",
            "telephone_number": "602-406-6262",
            "fax_number": "602-406-6261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-273-5550",
            "fax_number": "352-273-5575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "MICHAEL",
        "middle_name": "FARRIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "AZ",
            "license": "52108",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NY",
            "license": "327113",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "327113",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A78335",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME86883",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "52108",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279658900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.