Active NPI
Mary Ellen Waters, PT
- Physical Therapist
- Oswego, NY
National Provider Identifier
1922884675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 009837
- Practice address
- 2 Debbie LN
Oswego, NY 13126-6759 - Phone
- (315) 887-0221
- Fax
- (315) 216-4931
- NPI assigned
- Sep 7, 2023
- Last updated
- Sep 7, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 009837 | NY | Primary |
Addresses
Primary practice location
2 Debbie LN
Oswego, NY 13126-6759
Mailing address
1502 Owahgena Ter
Cazenovia, NY 13035-9631
Phone (315) 706-3386
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009837 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arc Rehab Services LLC | Physical Therapist | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1922884675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1502 OWAHGENA TER",
"city": "CAZENOVIA",
"state": "NY",
"postal_code": "130359631",
"telephone_number": "315-706-3386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 DEBBIE LN",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131266759",
"telephone_number": "315-887-0221",
"fax_number": "315-216-4931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "MARY",
"middle_name": "ELLEN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-07",
"last_updated": "2023-09-07",
"certification_date": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "009837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oswego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.