Individual provider Active NPI

Desmond James Watt, PA-C

  • Medical Physician Assistant
  • San Francisco, CA
National Provider Identifier
1134468515
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8507 Issued in AZ
Practice address
2 Embarcadero Ctr Lbby
San Francisco, CA 94111-3823
Phone
(415) 578-3100
Fax
(415) 252-7176
NPI assigned
Feb 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0007618 CO
Physician Assistant 363A00000X PA61373940 WA
Physician Assistant 363A00000X PA100475 MA
Physician Assistant 363A00000X 0010-14690 NC
Physician Assistant 363A00000X 11809 GA
Medical Physician Assistant 363AM0700X 51522 CA
Medical Physician Assistant 363AM0700X 018349 NY
Medical Physician Assistant 363AM0700X 085004547 IL
Medical Physician Assistant 363AM0700X 8507 AZ Primary

Addresses

Primary practice location

2 Embarcadero Ctr Lbby
San Francisco, CA 94111-3823

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

131 S Dearborn St Ste 1025
Chicago, IL 60603-5517
Phone (917) 261-4414

Other practice location 2

8600 W Bryn Mawr Ave # 130-8600
Chicago, IL 60631-3579
Phone (917) 261-4414

Other practice location 3

200 W Jackson Blvd Fl 10
Chicago, IL 60606-6910
Phone (917) 261-4414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8507AZMDChiropractor
PA.0007618COMDPhysician Assistant
PA100475MAMDPhysician Assistant
0010-14690NCMDPhysician Assistant
PA61373940WAMDPhysician Assistant
018349NYMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1134468515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EMBARCADERO CTR LBBY",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113823",
            "telephone_number": "415-578-3100",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 S Dearborn St Ste 1025",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606035517",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8600 W Bryn Mawr Ave # 130-8600",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606313579",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 W Jackson Blvd Fl 10",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606066910",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATT",
        "first_name": "DESMOND",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-05",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007618",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61373940",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA100475",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14690",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11809",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "51522",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "018349",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004547",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "8507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.