Active NPI
Hilary Stephen Watson II, M.D.
- Specialist
- Mandeville, LA
National Provider Identifier
1083782965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 10774R
- Practice address
- 1665 Dove Park Rd
Suite 700
Mandeville, LA 70471-1919 - Phone
- (985) 345-5500
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 10774R | LA | Primary |
Addresses
Primary practice location
1665 Dove Park Rd
Suite 700
Mandeville, LA 70471-1919
Mailing address
PO Box 2932
Hammond, LA 70404-2932
Phone (985) 345-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1991601 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031211000853 | LA | Practitioner - Urology | 8527964261 | Practice locations: Mandeville, LA |
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Louisiana State University School of Medicine in Shreveport, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1665 Dove Park Rd
Mandeville, LA 70471-1929
Phone (985) 345-5500
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10774R | LA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399939200000",
"number": "1083782965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2932",
"city": "HAMMOND",
"state": "LA",
"postal_code": "704042932",
"telephone_number": "985-345-5500",
"fax_number": "985-345-5555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1665 DOVE PARK RD",
"address_2": "SUITE 700",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704711919",
"telephone_number": "985-345-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "HILARY",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2014-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "LA",
"license": "10774R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1991601",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mandeville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.