Individual provider Active NPI

Jacqueline Watchmaker, M.D.

  • Dermatology Physician
  • Scottsdale, AZ
National Provider Identifier
1033568761
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
63274 Issued in AZ
Practice address
10900 N Scottsdale Rd
Scottsdale, AZ 85254-5216
Phone
(480) 210-1988
NPI assigned
Jun 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 267817 MA
Dermatology Physician 207N00000X 63274 AZ Primary

Addresses

Primary practice location

10900 N Scottsdale Rd
Scottsdale, AZ 85254-5216

Mailing address

10900 N Scottsdale Rd
Scottsdale, AZ 85254-5216
Phone (262) 391-7464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20211006002887 AZ Practitioner - Dermatology 0749553691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Medical College of Wisconsin, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Skin Specialists LLCGroup PAC ID 9739079864, 51 clinicians

Practice addresses (Care Compare)

4400 N 32ND St
Suite 140
Phoenix, AZ 85018-3964
Phone (602) 494-1817

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions258
Skin biopsy55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63274AZMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Skin Specialists LLC Dermatology CurrentSince Nov 1, 2021 Accepting new patients
Southwest Skin Specialists, LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

4400 N 32nd St
Ste 140
Phoenix, AZ 85018
Phone (602) 254-1429

11130 N Tatum Blvd
Ste 100
Phoenix, AZ 85028
Phone (602) 494-1817

10900 N Scottsdale Rd
Ste 201
Scottsdale, AZ 85254
Phone (480) 991-0280

4845 E Thunderbird Rd
Ste 2
Scottsdale, AZ 85254
Phone (602) 494-1817

10900 N Scottsdale Rd
Scottsdale, AZ 85254
Phone (480) 368-2500

10900 N Scottsdale Rd
Ste 202
Scottsdale, AZ 85254
Phone (602) 494-1817

10200 N 92nd St
Ste 205
Scottsdale, AZ 85258
Phone (602) 494-1817

Interoperability endpoints

  • Direct secure messaging: jwatchmaker@swskin.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1033568761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 N SCOTTSDALE RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545216",
            "telephone_number": "262-391-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 N SCOTTSDALE RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545216",
            "telephone_number": "480-210-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATCHMAKER",
        "first_name": "JACQUELINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "267817",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "63274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.