Individual provider Active NPI

Ashley R Watkins, LMSW

  • Social Worker
  • Syracuse, NY
National Provider Identifier
1083195184
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
108786-01 Issued in NY
Practice address
1045 James St
Syracuse, NY 13203-7043
Phone
(315) 472-4471
NPI assigned
Aug 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.020501 IL
Social Worker 104100000X 108786-01 NY Primary

Addresses

Primary practice location

1045 James St
Syracuse, NY 13203-7043

Mailing address

1109 E. Genesee St. Unit 2
Syracuse, NY 13210
Phone (312) 813-0703

Other practice location 1

1207 W Leland Ave Fl 5
Chicago, IL 60640-7043
Phone (773) 275-2586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250618003146 IL Practitioner - Clinical Social Worker 9032620794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brave Health Medical Group, PAGroup PAC ID 9537586052, 93 clinicians

Practice addresses (Care Compare)

9526 Osceola Ave
Morton Grove, IL 60053-1161
Phone (312) 477-2354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108786-01NYMDSocial Worker
149.020501ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Health Medical Group PA CurrentSince May 12, 2025 Accepting new patients

Locations

1951 NW 7th Ave
Ste 300
Miami, FL 33136
Phone 3059026347 ext. 20

1951 NW 7th Ave
Fl 3
Miami, FL 33136
Phone (305) 297-4749

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1083195184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 E. GENESEE ST. UNIT 2",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "312-813-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132037043",
            "telephone_number": "315-472-4471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 W Leland Ave Fl 5",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606407043",
            "country_code": "US",
            "telephone_number": "773-275-2586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "ASHLEY",
        "middle_name": "R",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020501",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "108786-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.