Kenneth W Waters, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

0101252186 Issued in VA

Practice address

Kaiser Permanente Tysons Corner Medical Center
8008 Westpark Drive
McLean, VA 22102

Phone

(703) 489-1405

NPI assigned

Dec 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, VA2 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 2

Specialty

Anesthesiology

Education

University of Vermont College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inova Cares - CommunityGroup PAC ID 9537526330, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwaters761889@soc.inova.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.

• Inova Cares - Community

  • Anesthesiology Physician
  • Fairfax, VA
  • NPI 1861131906

  DC

  Medicare reassignment Care Compare group NPD

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

• Inova Health Care Services

  • General Acute Care Hospital
  • Fairfax, VA
  • NPI 1760513980
  Care Compare affiliation

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1811065584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8008 WESTPARK DRIVE",
            "address_2": "MAPMG DEPT OF ANESTHESIA",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22102",
            "telephone_number": "703-489-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KAISER PERMANENTE TYSONS CORNER MEDICAL CENTER",
            "address_2": "8008 WESTPARK DRIVE",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22102",
            "telephone_number": "703-489-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KENNETH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2021-07-23",
        "certification_date": "2021-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0068100",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "DC",
            "license": "MD044841",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ME",
            "license": "MD17452",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ME",
            "license": "EC-05-170",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101252186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "Kaiser Permanente Tysons Corner Medical Center",
            "address_2": "8008 Westpark Drive",
            "city": "McLean",
            "state": "VA",
            "country_code": "US",
            "postal_code": "22102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Anesthesiology Physician in McLean, VA
• Providers in McLean, VA by specialty
• Anesthesiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.