Individual provider Active NPI

Katherine E Waters, NP

  • Pediatric Nurse Practitioner
  • Boston, MA
National Provider Identifier
1912305434
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2267247 Issued in MA
Practice address
300 Longwood Ave
Boston, MA 02115-5724
Phone
(617) 355-6000
NPI assigned
Dec 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2267247 MA
Pediatric Nurse Practitioner 363LP0200X RN2267247 MA Primary

Addresses

Primary practice location

300 Longwood Ave
Boston, MA 02115-5724

Mailing address

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150427001646 MA Practitioner - Nurse Practitioner 9830418748 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2267247MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Dana-Farber Cancer Institute, Inc. Current Accepting new patients
Children'S Hospital Pediatric Associates, Inc Pediatrics Past Accepting new patients
Childrens Hospital Boston Past Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

Interoperability endpoints

  • Direct secure messaging: waters.katherine.dfci@direct.partners.masshiway.net

Organizations & group practices 5

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": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1912305434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KATHERINE",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2267247",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2267247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.