Active NPI
Maureen Waters
- Physician Assistant
- Wynnewood, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA066467
- Practice address
- 100 E Lancaster Avenue
Suite 375 Medical Science Building
Wynnewood, PA 19096-3433 - Phone
- (610) 645-9093
- Fax
- (610) 645-9476
- NPI assigned
- Nov 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA066467 | PA | Primary |
| Physician Assistant | 363A00000X | 024441 | NY |
Addresses
Primary practice location
100 E Lancaster Avenue
Suite 375 Medical Science Building
Wynnewood, PA 19096-3433
Mailing address
3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone (484) 337-1632
Other practice location 1
1000 10th Ave
New York, NY 10019-1147
Phone (610) 781-4682
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
825 Old Lancaster Rd
Suite 250
Bryn Mawr, PA 19010-3239
Phone (484) 227-9700
830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118
Hospital & facility affiliations
- Bryn Mawr Hospital
- Main Line Hospital Lankenau
- Paoli Hospital
- Riddle Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA066467 | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fpa Hospital Based | Current | Accepting new patients |
Locations
1000 10th Ave
New York, NY 10019
Phone (212) 523-2369
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Newtown Square, PA
- NPI 1922077643
-
- Nuclear Medicine Physician
- New York, NY
- NPI 1629319413
-
- Dermatopathology (Pathology) Physician
- New York, NY
- NPI 1841531795
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Paoli, PA
- NPI 1215042114
-
- General Acute Care Hospital
- Wynnewood, PA
- NPI 1245335629
-
- General Acute Care Hospital
- Bryn Mawr, PA
- NPI 1508971441
-
- General Acute Care Hospital
- Media, PA
- NPI 1407856099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756857600000",
"number": "1962047290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3803 W CHESTER PIKE STE 160",
"city": "NEWTOWN SQUARE",
"state": "PA",
"postal_code": "190732336",
"telephone_number": "484-337-1632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E LANCASTER AVENUE",
"address_2": "SUITE 375 MEDICAL SCIENCE BUILDING",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190963433",
"telephone_number": "610-645-9093",
"fax_number": "610-645-9476"
}
],
"practiceLocations": [
{
"address_1": "1000 10th Ave",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100191147",
"country_code": "US",
"telephone_number": "610-781-4682",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATERS",
"first_name": "MAUREEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-11",
"last_updated": "2025-09-03",
"certification_date": "2025-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA066467",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "024441",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wynnewood, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.