NPIMap

Individual provider Active NPI

Ryan Scott Watson, M.D.

  • Surgery Physician
  • Virginia, MN
National Provider Identifier
1053757583
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
63994 Issued in MN
Practice address
1101 9TH St N
Virginia, MN 55792
Phone
(218) 741-0150
NPI assigned
May 10, 2013
Last updated
Aug 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 63994 MN Primary

Addresses

Primary practice location

1101 9TH St N
Virginia, MN 55792

Mailing address

400 East Third Street
Essentia Health Duluth Clinic McL2Cred
Duluth, MN 55805-1951
Phone (218) 786-3146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20180823001497 MN Practitioner - General Surgery 1254655178 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deer River Healthcare Center IncGroup PAC ID 1850388448, 14 clinicians
Essentia Health Virginia LLCGroup PAC ID 7810149002, 64 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

115 10TH Ave NE
Deer River, MN 56636-8795

2501 Keenan Dr
International Falls, MN 56649-2181
Phone (218) 283-9431

730 E 34TH St
Hibbing, MN 55746-2341
Phone (218) 262-5225

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy18
Hernia repair - groin (open)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux27
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63994MNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deer River Healthcare Center Inc CurrentSince Jun 17, 2019 Accepting new patients
Essentia Health Virginia, LLC CurrentSince Jan 3, 2019 Accepting new patients
Essentia Health Moose Lake Current Accepting new patients
Deer River Healthcare Center, Inc. CurrentSince Jun 17, 2019 Accepting new patients
Deer River Healthcare Center, Inc. Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Mar 10, 2021 Accepting new patients
Essentia Health Moose Lake CurrentSince Jan 3, 2022 Accepting new patients
Pine Medical Center CurrentSince Jan 3, 2022 Accepting new patients
Pine Medical Center CurrentSince Jan 3, 2022 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic LTD CurrentSince Mar 10, 2021 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
Essentia Health Virginia, LLC CurrentSince Jan 3, 2019 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
Essentia Health Virginia, LLC Past Accepting new patients
Deer River Healthcare Center, Inc Past Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
Duluth Graduate Medical Education Council Inc Past Accepting new patients

Locations

115 10th Ave NE
#A
Deer River, MN 56636
Phone (218) 246-8275

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319

300 W Conan St
Ely, MN 55731
Phone (218) 365-7900

1542 Golf Course Rd
Ste 204
Grand Rapids, MN 55744
Phone (218) 322-4900

730 E 34th St
Hibbing, MN 55746
Phone (218) 262-3425

2501 Keenan Dr
Intl Falls, MN 56649
Phone (218) 283-4481

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

705 Lundorff Dr
Sandstone, MN 55072
Phone (320) 245-2211

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

Organizations & group practices 19

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

View all 19

Hospital & facility affiliations 8

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": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1053757583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EAST THIRD STREET",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC MCL2CRED",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 9TH ST N",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "55792",
            "telephone_number": "218-741-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "RYAN",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-10",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "63994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia, MN

Sources for this page

Verify at the official NPI Registry.