Jamil Waters, MPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11758 Issued in TX

Practice address

4520 N Macarthur Blvd Ste 100
Irving, TX 75038-1235

Phone

(214) 630-5256

NPI assigned

Feb 20, 2018

Sex

Female

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blackburn Woolfolk Dermatology PLLCGroup PAC ID 3779875042, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: jwaters1305063@direct.texashealth.org

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.

• Blackburn Woolfolk Dermatology, PLLC

  • Dermatology Physician
  • Irving, TX
  • NPI 1447619291
  Medicare reassignment Care Compare group
• Raymond C. Blackburn, M.D.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1952789729
  NPD (past)

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1699275255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 N MACARTHUR BLVD STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750381235",
            "telephone_number": "214-630-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 N MACARTHUR BLVD STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750381235",
            "telephone_number": "214-630-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "JAMIL",
        "name_prefix": "Ms.",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Waren, MCD, CCC-SLP
• Taylor Shyann Warwick
• Robin Washington-White, LPC
• Myrana Washington
• Gilbert Tyler Wasserman Sr., ATP
• William Waters, M.D.
• Amber Watkins, LMT
• Jason Aubrey Watkins, D.C.
• Laura Watkins, RPH
• Candace Watley, SLPA

• Physician Assistant in Irving, TX
• Providers in Irving, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.