DR. LISA RENEE WATERMAN (D.O.) – Obstetrics & Gynecology Physician, NPI 1467455808

DR. LISA RENEE WATERMAN (D.O.) is a healthcare provider. based in Springdale, Arkansas. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials D.O.. They hold a License No. E-18839 (AR). The NPI Number for DR. LISA RENEE WATERMAN (D.O.) is 1467455808

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
DR. LISA RENEE WATERMAN (D.O.)
NPI
1467455808
Phone
(405) 413-4351
Address
5501 WILLOW CREEK DR STE 203
Enumeration Date
31 May 2005
Deactivation Date
20 March 2006
Reactivation Date
24 March 2006
Last Update Date
14 February 2025

Doctor Profile

Medical School Name
OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
-
Graduation Year
1996 (30 years ago)
PAC ID
1355526377
Group Practice PAC ID
0244213213
Professional Enrollment ID
I20250214002804
Address ID
AR727645374SP601XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:21State licenses:1Digital endpointsOther names

480 OBSTETRICS/GYNECOLOGY in OK

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Provider Addresses for DR. LISA RENEE WATERMAN (D.O.)

  • 5501 WILLOW CREEK DR STE 203

    SPRINGDALE, AR 727628708

    Phone: (405) 413-4351

    Fax: (479) 757-2942

    Type: Mailing

  • East Robinson Street, Norman, Cleveland County, Oklahoma, 73026, United States

    STE 2400

    NORMAN, OK 730716671

    Phone: (405) 360-1264

    Fax: (405) 321-8683

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 33 Open Payments records for all available years, with a total value of $13,417.

Total Amount is formed as General ($13,417) + Research ($0) + Ownership ($0) = $13,417.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($13,079).

Total Amount

$13,417

General + Research + Ownership

Payments

33

Total payment records

General Amount

$13,417

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2025-02-14

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250214002804IObstetrics/GynecologyARTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
76830Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina1311$0
View full utilization report →

Insurance plans in this area (ZIP 72762)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244213213View full group profile
NameSpecialtyState
Family PracticeAR
Nurse PractitionerAR
Nurse PractitionerAR
Orthopedic SurgeryAR
O B S T E T R I C S/ G Y N E C O L O G YAR
Thoracic SurgeryAR
Orthopedic Surgery, Sports MedicineAR
-AR
O B S T E T R I C S/ G Y N E C O L O G YAR
Orthopedic SurgeryAR

Reviews

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Frequently asked questions

What federal number belongs to DR. LISA RENEE WATERMAN (D.O.)?
The federal identifier for DR. LISA RENEE WATERMAN (D.O.) is NPI 1467455808.
Is DR. LISA RENEE WATERMAN (D.O.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does DR. LISA RENEE WATERMAN (D.O.) list a primary specialty?
If you are matching referrals, note Obstetrics & Gynecology Physician for DR. LISA RENEE WATERMAN (D.O.). Clinical services aligned with this taxonomy classification.
What location shows for DR. LISA RENEE WATERMAN (D.O.)?
We surface Springdale, Arkansas for DR. LISA RENEE WATERMAN (D.O.) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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