Individual provider Active NPI

Michael Patrick Waters, MD

  • Emergency Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1801829775
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A90012 Issued in CA
Practice address
751 Medical Center CT
Department of Emergency Medicine
Chula Vista, CA 91911-6617
Phone
(619) 482-5825
Fax
(619) 482-5833
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A90012 CA Primary

Addresses

Primary practice location

751 Medical Center CT
Department of Emergency Medicine
Chula Vista, CA 91911-6617

Mailing address

11184 Vista Sorrento Pkwy Apt 209
San Diego, CA 92130-7618
Phone (858) 481-4878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Jul 1, 2006 Accepting new patients
Scripps Health Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jul 1, 2006 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

751 Medical Center Ct
#1182
Chula Vista, CA 91911

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Interoperability endpoints

  • Direct secure messaging: mwaters31781@scrippshlth.medalliesdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1801829775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11184 VISTA SORRENTO PKWY APT 209",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921307618",
            "telephone_number": "858-481-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 MEDICAL CENTER CT",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116617",
            "telephone_number": "619-482-5825",
            "fax_number": "619-482-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A90012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.