Theresa A Waters, D. O.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

285798 Issued in NY

Practice address

510 Towne Dr
Fayetteville, NY 13066-1331

Phone

(315) 663-0500

Fax

(315) 663-0514

NPI assigned

Apr 7, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Lake Erie College of Osteopathic Medicine, Erie, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr inGroup PAC ID 3274445796, 277 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
• Oneida Health Hospital Hospital, Oneida, NY, CCN 330115

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twaters17458@direct.upstate.edu

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.

• Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1063468239
  Medicare reassignment Care Compare group NPD
• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Medicare reassignment NPD
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747

  Internal Medicine

  Medicare reassignment NPD
• Department of Medicine Medical Service Group

  • Hematology & Oncology Physician
  • Homer, NY
  • NPI 1205104262
  NPD
• North Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1972563070

  Internal Medicine

  NPD
• St Joseph's Hospital Health Center

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1699832436
  NPD
• St. Joseph's Pathology, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Syracuse, NY
  • NPI 1235121575
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Oneida Health Systems, Inc

  dba Oneida Healthcare Center

  • General Acute Care Hospital
  • Oneida, NY
  • NPI 1962408203
  Care Compare affiliation
• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1629393202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 TOWNE DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661331",
            "telephone_number": "315-663-0500",
            "fax_number": "315-663-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 TOWNE DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661331",
            "telephone_number": "315-663-0500",
            "fax_number": "315-663-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "THERESA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D. O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-07",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "61027",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "285798",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "285798",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04561226",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Joan Walsh, FNP-C
• Charles Brian Walton, LCSW
• Rui Wang
• Warby Parker Inc.
• Michael Nathen Warren, MPAS, PA-C
• Danielle Geneva Weekes, MD
• Wegmans Food Markets, Inc. (Wegmans Pharmacy #030)
• Andrew Michael Weinberg, D.O.
• Michael Weinstein, DDS
• Jill Weldum, LMFT

• Cardiovascular Disease Physician in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.