CONNOR ANDREW WATHEN – Neurological Surgery Physician, NPI 1619464989
Neurological Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
46 NEUROSURGERY in RI
Provider Addresses for CONNOR ANDREW WATHEN
117 ELLENFIELD ST STE 101
PROVIDENCE, RI 029054541
Phone:
Type: Mailing
593 EDDY STREET
APC 6
PHILADELPHIA, RI 029034923
Phone: (401) 793-9166
Type: Location
East Derbyshire Road, Euclid Heights, Cleveland Heights, Cuyahoga County, Ohio, 44118, United States
CLEVELAND HEIGHTS, OH 441182711
Phone: (770) 330-4458
Type: Mailing
Hospital of the University of Pennsylvania, 3400, Spruce Street, University City, Philadelphia, Philadelphia County, Pennsylvania, 19104, United States
PHILADELPHIA, PA 191044238
Phone: (770) 330-4458
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $75.
Total Amount is formed as General ($75) + Research ($0) + Ownership ($0) = $75.
Last reported payment date: 2024-08-25 • Largest payer in this snapshot: Stryker Corporation ($75).
Total Amount
$75
General + Research + Ownership
Payments
3
Total payment records
General Amount
$75
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $75 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-06-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250624002831 | I | Neurosurgery | RI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02905)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | RI | |
| - | RI | |
| Internal Medicine | RI | |
| Internal Medicine | RI | |
| - | RI | |
| Internal Medicine | RI | |
| P S Y C H I A T R Y | MI | |
| - | RI | |
| - | RI | |
| P S Y C H I A T R Y | RI |
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