DR. PATRICK TIMOTHY WATERS (NPI# 1356302715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356302715 |
| Entity Type | Individual |
| Full Name | DR. PATRICK TIMOTHY WATERS |
| Credential | D.O., F.A.A.F.P |
| Practice Address |
2101 W Lehigh Ave Ste A Philadelphia PA 19132-2664 |
| Mailing Address |
1395 Nw 167th St Miami Gardens FL 33169-5710 |
| Practice Telephone | 2678667211 |
| Mailing Telephone | 2678667211 |
| Mailing Fax Number | 2672027398 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2020-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
0S003179L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | AETNA HMO ONLY | 85987 | 01 |
| PA | KEYSTONE AND BLUE INDIV # | 0058143000 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700016904 | Patrick Joseph Waters | Dentist | 2304 Midwestern Pkwy Ste 102, Wichita Falls, TX 76308-2332 | 2009-07-22 |
| 1831279421 | Patrick J. Waters | Social Worker | 1727 Wrightsboro Rd Ste B, Augusta, GA 30904-4074 | 2006-10-17 |
| 1205941200 | Patrick William Waters | Pharmacist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2006-08-20 |
| 1720084718 | Patrick R Waters | Urology | 2800 Hayes Ave, Bldg D, Sandusky, OH 44870-7252 | 2005-06-23 |
| Street Address |
2101 W LEHIGH AVE STE A |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19132-2664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891267753 | Ardi Hermawan | Nurse Practitioner | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2018-12-17 |
| 1952804312 | Dedicated Pennsylvania Holding, LLC | Specialist | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2018-03-13 |
| 1982133195 | Mica Natasha Winchester | Internal Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2017-06-09 |
| 1932536232 | Ephraim Dunn | Family Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132 | 2013-10-01 |
| 1811256019 | Sharda Mukunda | Internal Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2012-05-08 |
| 1730491770 | Naiema A Benson | Internal Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2010-07-07 |
| 1518975325 | Kostiya Kana Peki | Internal Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811511017 | Irene Maria Clark | Social Worker | 3101 N. 29th St., Philadelphia, PA 19132 | 2020-06-03 |
| 1518407519 | Forget Me Knot Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 2321 N Broad Street, Philadelphia, PA 19132 | 2017-02-24 |
| 1609322437 | Shaakira Gillette | Social Worker | 2514 N. Broad St, Philadelphia, PA 19132 | 2016-08-31 |
| 1578017042 | Education Plus, Inc. | Nurse Practitioner | 3217 W. Clearfield Street, Philadelphia, PA 19132 | 2016-08-12 |
| 1972958544 | Rittenhouse Health LLC | Substance Abuse Rehabilitation Facility | 2321 N. Broad St, Philadelphia, PA 19132 | 2016-05-02 |
| 1336593458 | Jamal Vann | Counselor | 2233-43 West Allegheny Avenue, Philadelphia, PA 19132 | 2016-04-14 |
| 1487027132 | Jazzmin Devine | Specialist/Technologist | 200 Prospect St Hemlock 430a, East Stroudsburg University, PA 19132 | 2015-11-03 |
| 1609282508 | Lawrence Petitfrere | Pharmacist | 2801 W Dauphin St, Philadelphia, PA 19132 | 2014-07-11 |
| 1437565157 | Mental Health Partnerships | Community/Behavioral Health | 2709 N. Broad Street, Philadelphia, PA 19132 | 2014-07-02 |
| 1477977346 | Randy Morman | Counselor | 2514 N. Broad Street, 1st Floor, Philadelphia, PA 19132 | 2014-02-12 |
| Find all providers in zip 19132 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801378740 | Temple Faculty Practice Plan Inc | Family Medicine | 3322 Broad St, Philadelphia, PA 19140-5103 | 2018-09-06 |
| 1043232531 | Barry L Marks | Family Medicine | 6302 Morton St, Philadelphia, PA 19144 | 2006-07-24 |
| 1841833548 | Tower Drexel Academic Medical Group LLC | Family Medicine | 10 Shurs Ln Ste 203, Philadelphia, PA 19127-2123 | 2019-10-25 |
| 1164879862 | Hishen Dang | Family Medicine | 3615 Chestnut St, Philadelphia, PA 19104-2612 | 2016-05-23 |
| 1326492570 | Michael Lawrence Weissberger | Family Medicine | 833 Chestnut St, Suite 301, Philadelphia, PA 19107-4414 | 2016-04-14 |
| 1033575352 | Methodist Associates In Healthcare, Inc. | Family Medicine | 2301 S Broad St, Philadelphia, PA 19148-3542 | 2016-01-04 |
| 1104205400 | Residentialist Housecall Med Grp, PC A Pennsylvania Corp | Family Medicine | 4190 City Ave, Pcom - Rowland Hall, Room 528, Philadelphia, PA 19131-1626 | 2015-05-20 |
| 1548689581 | Elizabeth Collins | Family Medicine | 833 Chestnut St, Suite 301, Philadelphia, PA 19107-4414 | 2014-04-07 |
| 1285959510 | Aroonsiri Howell | Family Medicine | 3322 N Broad St, Philadelphia, PA 19140 | 2010-03-30 |
| 1265674592 | Bravo Health Advanced Care Center, P.C. | Family Medicine | 1601 Chestnut St, Philadelphia, PA 19192-4071 | 2009-04-01 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19132 |
Please comment or provide details below to improve the information on DR. PATRICK TIMOTHY WATERS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.