Individual provider Active NPI

Matthew James Waterman, PA-S2

  • Physician Assistant
  • Englewood, CO
National Provider Identifier
1881443729
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0009573 Issued in CO
Practice address
8401 S Chambers Rd
Englewood, CO 80112-3276
Phone
(949) 212-6145
NPI assigned
May 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA.0009573 CO Primary

Addresses

Primary practice location

8401 S Chambers Rd
Englewood, CO 80112-3276

Mailing address

2080 California St Apt 438
Denver, CO 80205-4997
Phone (949) 212-6145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20260410000883 CO Practitioner - Physician Assistant 1658846373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1460 Little Raven St
Unit 2 333
Denver, CO 80202-1767

PO Box
Denver, CO 80217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA.0009573COMDPhysician Assistant

Organizations & group practices 1

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": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1881443729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CALIFORNIA ST APT 438",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802054997",
            "telephone_number": "949-212-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 S CHAMBERS RD",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801123276",
            "telephone_number": "949-212-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "credential": "PA-S2",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-14",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0009573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.