NPIMap

Individual provider Active NPI

Angela Ellise Watson, PAC

  • Physician Assistant
  • Springfield, OR
National Provider Identifier
1003823022
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00394 Issued in OR
Practice address
2400 Hartman LN
Springfield, OR 97477-1118
Phone
(541) 334-3350
Fax
(541) 284-5198
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00394 OR Primary

Addresses

Primary practice location

2400 Hartman LN
Springfield, OR 97477-1118

Mailing address

2400 Hartman LN
Springfield, OR 97477-1118
Phone (541) 334-3350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070131000540 OR Practitioner - Physician Assistant 0446252647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oregon Urology Institute PCGroup PAC ID 6608766399, 33 clinicians

Practice addresses (Care Compare)

1007 Harlow Rd
FL 3
Springfield, OR 97477-7124
Phone (541) 334-3350

2400 Hartman LN
Springfield, OR 97477-1118
Phone (541) 334-3350

2400 Hartman LN
Suite 200
Springfield, OR 97477-1122

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Roseburg, OR, CCN 380027
  • Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090
  • Peace Harbor Medical Center Hospital, Florence, OR, CCN 381316
  • Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102
  • Peacehealth Cottage Grove Community Medical Center Hospital, Cottage Grove, OR, CCN 381301

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
82.68 of 100Reported as group
Quality
73.02
Promoting interoperability
80
Improvement activities
40
Cost
85.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00394ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Anesthesiology Group PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: awatso02@yourcarecommunity.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1003823022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 HARTMAN LN",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771118",
            "telephone_number": "541-334-3350",
            "fax_number": "541-284-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HARTMAN LN",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771118",
            "telephone_number": "541-334-3350",
            "fax_number": "541-284-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ANGELA",
        "middle_name": "ELLISE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.