DR. PATRICK TIMOTHY WATERS D.O. F.A.A.F.P NPI 1356302715

NPI Information

  • NPI: 1356302715
  • Provider Name: DR. PATRICK TIMOTHY WATERS, D.O., F.A.A.F.P
  • Classification: Family Medicine - 207QG0300X
  • Specialization: Geriatric Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2101 W LEHIGH AVE STE A
    PHILADELPHIA, PA
    ZIP 19132
  • Phone: (267) 866-7211

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NPI Details

DR. Patrick Timothy Waters, D.O., F.A.A.F.P is a geriatric medicine family medicine in Philadelphia, PA with 53 years of experience. The provider is 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. DR. Patrick Timothy Waters, D.O., F.A.A.F.P NPI is 1356302715. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:1973

The provider's business location address is:

2101 W LEHIGH AVE STE A
PHILADELPHIA, PA
ZIP 19132-664
Phone: (267) 866-7211

The NPI 1356302715 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/28/2006 and was last updated on 3/17/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QG0300XFamily MedicineGeriatric Medicine0S003179LPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
185987OTHERPENNSYLVANIAAETNA HMO ONLY
20058143000OTHERPENNSYLVANIAKEYSTONE AND BLUE INDIV #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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