KATELYN VAN DE WATER CAA
NPI 1104476985
Anesthesiologist Assistant in Fort Myers, FL

Active since September 13, 2019Accepts Medicare Assignment
80.25/100
CMS Quality Rating
2776 CLEVELAND AVE, FORT MYERS, FL 33901(239) 343-2000 Get Directions Write a Review

NPPES record last updated: October 2, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 2, 2019, Sep 13, 2019 (2 updates tracked since 2019).

About Katelyn Van De Water Caa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATELYN VAN DE WATER CAA (NPI 1104476985) is an individual anesthesiologist assistant in Fort Myers, Florida, licensed in Florida (AA544) and active in the NPI registry since September 2019. She is affiliated with Mercy Regional Medical Center and is a graduate of Other (2019).

NPPES Registry Identity

NPI1104476985
Entity TypeIndividualFemale
Primary Taxonomy367H00000X
Provider Legal NameKATELYN VAN DE WATERCredential: CAA
Location Address2776 CLEVELAND AVEFort Myers, FL 33901-5864
Mailing Address14935 Hawksmoor Run CirOrlando, FL 32828-7511
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateSeptember 13, 2019
Last NPPES UpdateOctober 2, 20192 updates tracked since enumeration
NPI 1104476985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367H00000X
License Licensed in FL · AA544
Definition
An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.
2776 CLEVELAND AVE, Fort Myers, FL 33901

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Katelyn Van De Water Caa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4688906175
PECOS Enrollment IDI20241105001899

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for other procedure on upper abdomen 00790
Anesthesia for an upper abdomen procedure involves using medications to help you feel no pain during the operation. It can be general, where you're unconscious, or regional, where just the abdomen area is numbed. It ensures comfort and stillness, aiding a successful procedure.
11 services11 patients
Anesthesia for other procedure on large bowel using an endoscope 00811
Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Regional Medical Center

Acute Care Hospitals · Lorain, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360172
Location3700 Kolbe RoadLorain, OH 44053 · Lorain County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality83.44
Improvement Activities40
Cost64.53

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Anesthesiologist Assistant
2776 CLEVELAND AVE
FORT MYERS, FL 33901
Physician Assistant
2776 CLEVELAND AVE
FORT MYERS, FL 33901
Pharmacist
2776 CLEVELAND AVE
FORT MYERS, FL 33901
Emergency Medicine
2776 CLEVELAND AVE
FORT MYERS, FL 33901
Emergency Medicine
2776 CLEVELAND AVE
FORT MYERS, FL 33901
Physician Assistant (Medical)
2776 CLEVELAND AVE
FORT MYERS, FL 33901
Emergency Medicine
2776 CLEVELAND AVE
FORT MYERS, FL 33901
Physician Assistant
2776 CLEVELAND AVE
FORT MYERS, FL 33901

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katelyn Van De Water's NPI number?

The NPI number for Katelyn Van De Water is 1104476985. It was assigned to this individual provider in the NPPES registry on September 13, 2019.

Where is Katelyn Van De Water located?

Katelyn Van De Water practices at 2776 Cleveland Ave, Fort Myers, FL 33901. The listed phone number is (239) 343-2000.

What is Katelyn Van De Water's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Katelyn Van De Water enrolled in Medicare?

Yes. Katelyn Van De Water is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Katelyn Van De Water affiliated with any hospitals?

According to CMS data, Katelyn Van De Water is affiliated with Mercy Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Katelyn Van De Water was last updated on October 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.