KATELYN VAN DE WATER CAA
NPI 1104476985
Anesthesiologist Assistant in Fort Myers, FL
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
2Medicare enrollment records show Katelyn Van De Water reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Maitland, FL 32751
- Reassigned Medicare billing, Florida enrollment
- 2,356 clinicians in this Medicare group
Elyria, OH 44035
- Reassigned Medicare billing, Ohio enrollment
- 106 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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, OHMedicare 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.
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.
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.
Which organizations bill Medicare for Katelyn Van De Water's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Katelyn Van De Water reassigns Medicare benefits to 2 organizations: Us Anesthesia Partners Of Florida Inc. (Maitland, FL) and Elyria Anesthesia Incorporated (Elyria, OH). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Katelyn Van De Water's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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 7 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.
# Katelyn Van De Water, CAA · NPI 1104476985
Anesthesiologist Assistant physician in Fort Myers, Florida. Individual provider, active in the CMS NPPES registry since September 13, 2019.
## Identity
- **NPI:** 1104476985 (Entity type: Individual)
- **Enumerated:** September 13, 2019
- **Primary specialty:** Anesthesiologist Assistant · taxonomy 367H00000X
- **State license:** AA544 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 2776 CLEVELAND AVE, Fort Myers, FL 33901-5864
- **Phone:** (239) 343-2000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Us Anesthesia Partners Of Florida Inc. (NPI 1518910520, Maitland, FL); Elyria Anesthesia Incorporated (NPI 1710922463, Elyria, OH) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** October 2, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1104476985) · Data from the CMS NPPES public registry.