Physician Compare National (NPI:1811955958)

HEALTHCARE PROVIDER: PAUL FREDERICK WATERS M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1811955958
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6901893171
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050518000666
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WATERS
	Individual professional last name
Provider First Name	PAUL
	Individual professional first name
Provider Middle Name	F
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1974
	Individual professional's medical school graduation year
Primary Specialty	THORACIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	SURGICAL ONCOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	SURGICAL ONCOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	77 LAFAYETTE PL
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 302
	Group Practice or individual's line 2 address
City	GREENWICH
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	068305426
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	070018
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GREENWICH HOSPITAL ASSOCIATION -
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y