NPIMap

Individual provider Active NPI

Patrick R Waters, MD

  • Urology Physician
  • Sandusky, OH
National Provider Identifier
1720084718
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35071687 Issued in OH
Practice address
2800 Hayes Ave
BLDG D
Sandusky, OH 44870-7252
Phone
(419) 627-8771
Fax
(419) 627-0363
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35071687 OH Primary

Addresses

Primary practice location

2800 Hayes Ave
BLDG D
Sandusky, OH 44870-7252

Mailing address

2800 Hayes Ave
BLDG D
Sandusky, OH 44870-7252
Phone (419) 627-8771

Other identifiers 4

IdentifierTypeStateIssuer
000000204296OtherOHANTHEM
2592762OtherOHAETNA
04073OtherOHPARAMOUNT
2046119MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091118000753 OH Practitioner - Urology 5698845105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical College of Wisconsin, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fisher-Titus Medical Care LLCGroup PAC ID 6507940566, 82 clinicians

Practice addresses (Care Compare)

2800 Hayes Ave
BLDG D
Sandusky, OH 44870-7252
Phone (419) 627-8771

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35071687OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fisher-Titus Medical Care LLC CurrentSince Jan 7, 2019 Accepting new patients
Fisher-Titus Medical Center Current Accepting new patients
Northwest Columbus Urology, Inc. Past Accepting new patients

Locations

290 Progress Dr
Ste C
Bellevue, OH 44811
Phone (419) 484-1701

1355 W Main St
Ste D
Bellevue, OH 44811
Phone (419) 483-1001

278 Benedict Ave
Ste 650
Norwalk, OH 44857
Phone (419) 660-9675

34 Executive Dr
Norwalk, OH 44857
Phone (419) 668-0680

272 Benedict Ave
Norwalk, OH 44857
Phone (419) 668-1341

2800 Hayes Ave
Bldg D
Sandusky, OH 44870
Phone (419) 627-8771

Organizations & group practices 3

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 9

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1720084718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 HAYES AVE",
            "address_2": "BLDG D",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448707252",
            "telephone_number": "419-627-8771",
            "fax_number": "419-627-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 HAYES AVE",
            "address_2": "BLDG D",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448707252",
            "telephone_number": "419-627-8771",
            "fax_number": "419-627-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "PATRICK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35071687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000204296",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2592762",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "04073",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2046119",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.