Individual provider Active NPI

Joanna Hwang Watkins, MD

  • Otolaryngology Physician
  • Bloomington, IN
National Provider Identifier
1124079496
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
01071343A Issued in IN
Practice address
2920 S McIntire Dr
Suite 350
Bloomington, IN 47403-4221
Phone
(812) 332-7337
Fax
(812) 339-2934
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 47798 WI
Otolaryngology Physician 207Y00000X 01071343A IN Primary
Otolaryngology Physician 207Y00000X A105519 CA

Addresses

Primary practice location

2920 S McIntire Dr
Suite 350
Bloomington, IN 47403-4221

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1115 Ronald Reagan Pkwy
Avon, IN 46123-6910
Phone (317) 217-2300

Other identifiers 3

IdentifierTypeStateIssuer
201074450MedicaidIN
1124079496OtherINANTHEM PTAN
000000775353OtherINANTHEM PTAN

Other names 1

  • Joanna Hwang Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JWATKINS1@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20120720000016 IN Practitioner - Otolaryngology 3274681192 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Vanderbilt University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1115 N Ronald Reagan Pkwy
Avon, IN 46123-6910
Phone (317) 944-6467

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Iu Health West Hospital Hospital, Avon, IN, CCN 150158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47798WIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
University Otolaryngology Associates, Inc. Otolaryngology CurrentSince Sep 1, 2022 Accepting new patients

Locations

7631 Solutions Ctr
Chicago, IL 60677

1115 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-2500

2900 16th St
Bedford, IN 47421
Phone (812) 275-1200

2920 S McIntire Dr
Ste 350
Bloomington, IN 47403
Phone (812) 332-2226

2920 S McIntire Dr
Ste 250
Bloomington, IN 47403
Phone (812) 332-9217

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: jwatkins1@direct.iuhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1124079496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 S MCINTIRE DR",
            "address_2": "SUITE 350",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034221",
            "telephone_number": "812-332-7337",
            "fax_number": "812-339-2934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 Ronald Reagan Pkwy",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "IN",
            "postal_code": "461236910",
            "country_code": "US",
            "telephone_number": "317-217-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "JOANNA",
        "middle_name": "HWANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "47798",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01071343A",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A105519",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201074450",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "1124079496",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000000775353",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JWATKINS1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2920 S McIntire Dr",
            "address_2": "Suite 350",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474034221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "HWANG",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.