Individual provider Active NPI

Amina T Watson, M.D.

  • Pediatrics Physician
  • Bowie, MD
National Provider Identifier
1083610760
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0057065 Issued in MD
Practice address
1700 Science Drive
Suite 102
Bowie, MD 20715
Phone
(240) 556-1000
NPI assigned
Jun 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0057065 MD Primary

Addresses

Primary practice location

1700 Science Drive
Suite 102
Bowie, MD 20715

Mailing address

3100 Wyman Park Dr
Baltimore, MD 21211-2803
Phone (240) 556-1000

Other identifiers 5

IdentifierTypeStateIssuer
B776-0016OtherDCBCBS DC
1851473722OtherMDGROUP NPI - MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
837102400MedicaidMD
1427093343OtherMDGROUP NPI - UPPER MARLBORO FAMILY MEDICAL CENTER
61795003OtherMDBCBS MD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20110104001207 DC Practitioner - Pediatric Medicine 9032308200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Johns Hopkins University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14207 Park Ctr Dr
Suite 102
Laurel, MD 20707-5255
Phone (301) 604-5254

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0057065MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians CurrentSince Jan 4, 2012 Accepting new patients
Johns Hopkins Community Physicians, Inc Pediatrics CurrentSince Jan 4, 2012 Accepting new patients
Medical & Surgical Clinics of Southern Maryland Inc Pediatrics Past Accepting new patients

Locations

3100 Wyman Park Dr
Baltimore, MD 21211
Phone (410) 338-3000

14207 Park Center Dr
Ste 102
Laurel, MD 20707
Phone (301) 604-5254

9910 Franklin Square Dr
#2110
Nottingham, MD 21236
Phone (410) 933-5412

Interoperability endpoints

  • Direct secure messaging: awatson6805@direct.hopkinsmedicine.org

Organizations & group practices 4

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1083610760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 WYMAN PARK DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112803",
            "telephone_number": "240-556-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SCIENCE DRIVE",
            "address_2": "SUITE 102",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20715",
            "telephone_number": "240-556-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "AMINA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0057065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DC",
            "identifier": "B776-0016",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI - MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND",
            "identifier": "1851473722",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "837102400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI - UPPER MARLBORO FAMILY MEDICAL CENTER",
            "identifier": "1427093343",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "61795003",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.