Individual provider Active NPI

Robert William Watrous, MD

  • Addiction Medicine (Family Medicine) Physician
  • San Bernardino, CA
National Provider Identifier
1013084821
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
G81561 Issued in CA
Practice address
250 S G St
San Bernardino, CA 92410-3320
Phone
(909) 382-7100
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X G81561 CA Primary
Addiction Medicine (Family Medicine) Physician 207QA0401X 50616 CO

Addresses

Primary practice location

250 S G St
San Bernardino, CA 92410-3320

Mailing address

250 S G St
San Bernardino, CA 92410-3320
Phone (909) 382-7100

Other identifiers 2

IdentifierTypeStateIssuer
022362OtherCOKAISER COMMERCIAL NUMBER
63631717MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081106000456 CA Practitioner - Addiction MedicinePractitioner - Internal Medicine 2062571920 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Addiction MedicineAlso: Internal Medicine
Education
Loma Linda University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sac Health SystemGroup PAC ID 4385533579, shared by 13 NPIs, 222 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

1454 E 2ND St
San Bernardino, CA 92408-0118
Phone (909) 382-7100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
81561CAMDMarriage & Family Therapist
G81561CAMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Jul 11, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 1, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 1, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System CurrentSince Apr 16, 2021 Accepting new patients
Sac Health System CurrentSince Apr 16, 2021 Accepting new patients
Permanente Medical Group Inc CurrentSince Jul 11, 2016 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11370 Anderson St
#3650
Loma Linda, CA 92354

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1710 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

2829 Watt Ave
Sacramento, CA 95821
Phone (916) 418-0828

250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Interoperability endpoints

  • Direct secure messaging: rwatrous348205@direct.llu.edu

Organizations & group practices 10

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 1

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1013084821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "909-382-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "909-382-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATROUS",
        "first_name": "ROBERT",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": "G81561",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CO",
            "license": "50616",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "022362",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63631717",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.