Individual provider Active NPI

Adia Watts, LMT

  • Massage Therapist
  • Lynbrook, NY
National Provider Identifier
1073238804
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
033768-01 Issued in NY
Practice address
156 Scranton Ave
Lynbrook, NY 11563-2814
Phone
(516) 321-0397
NPI assigned
Oct 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 18KT01440600 NJ
Massage Therapist 225700000X 033768-01 NY Primary

Addresses

Primary practice location

156 Scranton Ave
Lynbrook, NY 11563-2814

Mailing address

12019 192ND St
Saint Albans, NY 11412-3626
Phone (347) 551-0342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18KT01440600NJMDMassage Therapist
033768-01NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hoboken Women'S Wellness Massage Therapist PastSince Mar 20, 2025 Accepting new patients

Organizations & group practices 1

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": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1073238804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12019 192ND ST",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114123626",
            "telephone_number": "347-551-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 SCRANTON AVE",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632814",
            "telephone_number": "516-321-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "ADIA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NJ",
            "license": "18KT01440600",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "033768-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.