KENNETH A WATERSON PA
NPI 1316255417
Physician Assistant - Surgical in Grand Rapids, MI

Active since September 23, 2010PECOS EnrolledAccepts Medicare Assignment
70.14/100
CMS Quality Rating
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525(616) 459-7101(616) 464-6170 Get Directions Write a Review

NPPES record last updated: December 30, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kenneth A Waterson Pa NPPES

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

KENNETH A WATERSON PA (NPI 1316255417) is an individual surgical provider in Grand Rapids, Michigan, licensed in Michigan (5601005898) and active in the NPI registry since September 2010. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1316255417
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameKENNETH A WATERSONCredential: PA
Location Address1111 LEFFINGWELL AVE NEGrand Rapids, MI 49525-6406
Mailing Address1111 Leffingwell Ave NeGrand Rapids, MI 49525-6406 · (616) 459-7101 · Fax (616) 464-6170
Fax(616) 464-6170
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateSeptember 23, 2010
Last NPPES UpdateDecember 30, 2013
NPI 1316255417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License Licensed in MI · 5601005898
Also ListedPhysician AssistantTaxonomy 363A00000X · License 5601005898 (MI)
1111 LEFFINGWELL AVE NE, Grand Rapids, MI 49525

Other Identifiers 3

Medicare PIN0M74460367MI
OtherOD14869MI · Group Ptan
Medicare PIND14869124MI

Accepted Insurance

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

Kenneth A Waterson Pa 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 ID9931396561
PECOS Enrollment IDI20101208001321
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 12

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.

Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
111 services52 patients
X-ray of knee, 1-2 views 73560
An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.
100 services76 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
92 services16 patients
X-ray of hip, 2-3 views 73502
An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
78 services62 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
68 services64 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
37 services37 patients

Hospital Affiliations CMS Care Compare

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

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230038
Location100 Michigan St NEGrand Rapids, MI 49503 · Kent 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.

70.14/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality56.75
Promoting Interoperability62
Improvement Activities40
Cost75.4

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.

Physician Assistant (Surgical)
1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI 49525
Orthopaedic Surgery
1111 LEFFINGWELL AVE NE, SUITE 100
GRAND RAPIDS, MI 49525
Occupational Therapist
1111 LEFFINGWELL AVE NE, SUITE 200
GRAND RAPIDS, MI 49525
Orthopaedic Surgery
1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI 49525
Orthopaedic Surgery
1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI 49525
Orthopaedic Surgery (Hand Surgery)
1111 LEFFINGWELL AVE NE, SUITE 200
GRAND RAPIDS, MI 49525
Occupational Therapist
1111 LEFFINGWELL AVE NE, SUITE 200
GRAND RAPIDS, MI 49525
Physician Assistant (Surgical)
1111 LEFFINGWELL AVE NE, STE 100
GRAND RAPIDS, MI 49525

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 Kenneth Waterson's NPI number?

The NPI number for Kenneth Waterson is 1316255417. It was assigned to this individual provider in the NPPES registry on September 23, 2010.

Where is Kenneth Waterson located?

Kenneth Waterson practices at 1111 Leffingwell Ave NE, Grand Rapids, MI 49525. The listed phone number is (616) 459-7101.

What is Kenneth Waterson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Kenneth Waterson enrolled in Medicare?

Yes. Kenneth Waterson 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.

What insurance does Kenneth Waterson accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and Priority Health list Kenneth Waterson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kenneth Waterson affiliated with any hospitals?

According to CMS data, Kenneth Waterson is affiliated with Spectrum Health.

When was this NPI record last updated?

The NPPES record for Kenneth Waterson was last updated on December 30, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.