Individual provider Active NPI

Susan Austin Watson, M.D.

  • Ophthalmology Physician
  • Raleigh, NC
National Provider Identifier
1184685646
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
30512 Issued in NC
Practice address
11081 Forest Pines Dr
Raleigh, NC 27614-7655
Phone
(252) 231-0424
Fax
(252) 231-0580
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 30512 NC Primary
Ophthalmology Physician 207W00000X 0101039474 VA

Addresses

Primary practice location

11081 Forest Pines Dr
Raleigh, NC 27614-7655

Mailing address

512 Shady Circle Dr
Rocky Mount, NC 27803-1715
Phone (252) 231-0424

Other identifiers 2

IdentifierTypeStateIssuer
86013OtherNCBCBS
8986013MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20100111000361 NC Practitioner - Ophthalmology 0648216697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Cincinnati College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11081 Forest Pines Dr
Suite 112
Raleigh, NC 27614-7656
Phone (252) 478-3736

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101039474VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Watson Dry Eye Center, PA Ophthalmology CurrentSince Oct 18, 1989 Accepting new patients
Watson Eye Associates, PA CurrentSince Oct 18, 1989 Accepting new patients

Locations

11081 Forest Pines Dr
Ste 120
Raleigh, NC 27614

11081 Forest Pines Dr
Ste 112
Raleigh, NC 27614
Phone (252) 478-3736

Interoperability endpoints

  • Direct secure messaging: swatson114234@direct.unc.nchie.net

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1184685646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 SHADY CIRCLE DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278031715",
            "telephone_number": "252-231-0424",
            "fax_number": "252-231-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11081 FOREST PINES DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147655",
            "telephone_number": "252-231-0424",
            "fax_number": "252-231-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "SUSAN",
        "middle_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "30512",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101039474",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86013",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8986013",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.