Individual provider Active NPI

Jannet Elizabeth Wright-Watson, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1184740714
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003623 Issued in NY
Practice address
1650 Grand Concourse
Suite 8C
Bronx, NY 10457
Phone
(718) 960-1400
Fax
(718) 960-2077
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003623 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Suite 8C
Bronx, NY 10457

Mailing address

4 Witmer CT
Islandia, NY 11749-6134
Phone (631) 234-0614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040707000164 NY Practitioner - Physician Assistant 1951388032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kings Medical Family Practice, P.C.Group PAC ID 4082989645, 18 clinicians

Practice addresses (Care Compare)

1295 Broadway
Brooklyn, NY 11221-2973
Phone (718) 682-3903

16814 Jamaica Ave
Jamaica, NY 11432-5216
Phone (718) 650-5553

9525 Church Ave
Brooklyn, NY 11212-2433
Phone (718) 650-5551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003623NYMDPhysician Assistant

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184740714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WITMER CT",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117496134",
            "telephone_number": "631-234-0614",
            "fax_number": "718-960-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "address_2": "SUITE 8C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10457",
            "telephone_number": "718-960-1400",
            "fax_number": "718-960-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT-WATSON",
        "first_name": "JANNET",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.