Individual provider Active NPI

Thomas Lee Watson, M.D.

  • General Practice Physician
  • Escondido, CA
National Provider Identifier
1104865781
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A52193 Issued in CA
Practice address
303 S Juniper St
Escondido, CA 92025-4924
Phone
(760) 480-9051
Fax
(760) 480-9054
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A52193 CA Primary

Addresses

Primary practice location

303 S Juniper St
Escondido, CA 92025-4924

Mailing address

303 S Juniper St
Escondido, CA 92025-4924
Phone (760) 480-9051

Other identifiers 1

IdentifierTypeStateIssuer
00521930MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050825001042 CA Practitioner - General PracticePractitioner - Emergency Medicine 8022049386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

303 S Juniper St
Escondido, CA 92025-4924
Phone (760) 480-9051

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Carmen General Practice CurrentSince Sep 1, 2016 Accepting new patients

Locations

301 E Washington Ave
Ste B
Escondido, CA 92025
Phone (760) 480-9051

303 S Juniper St
Escondido, CA 92025
Phone (760) 480-9051

13373 Perris Blvd
Ste C202A
Moreno Valley, CA 92553
Phone (951) 242-8155

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: thomas.watson.1@11763.direct.athenahealth.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73178
  • FHIR API: https://api.platform.athenahealth.com/11763/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1104865781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S JUNIPER ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254924",
            "telephone_number": "760-480-9051",
            "fax_number": "760-480-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S JUNIPER ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254924",
            "telephone_number": "760-480-9051",
            "fax_number": "760-480-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "THOMAS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A52193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00521930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.