Individual provider Active NPI

Mariel Olivia Watkins, MD

  • Otolaryngology Physician
  • Creve Coeur, MO
National Provider Identifier
1194348540
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
2025029374 Issued in MO
Practice address
1044 N Mason Rd
Dept Otolaryngology, Ste L10
Creve Coeur, MO 63141-6431
Phone
(314) 996-3880
Fax
(314) 996-8610
NPI assigned
May 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 2025029374 MO
Otolaryngology Physician 207Y00000X 2025029374 MO Primary

Addresses

Primary practice location

1044 N Mason Rd
Dept Otolaryngology, Ste L10
Creve Coeur, MO 63141-6431

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 996-3880

Other practice location 1

915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone (314) 652-4100

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20250806001514 MO Practitioner - Otolaryngology 5395166987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Meharry Medical College School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

660 S Euclid Ave Box
8115 Dept of Otolaryngology
Saint Louis, MO 63110-1010
Phone (314) 362-7509

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Aug 1, 2025 Accepting new patients
Washington University CurrentSince Aug 1, 2025 Accepting new patients
Washington University Past Accepting new patients

Locations

1044 N Mason Rd
Ste L10
Creve Coeur, MO 63141
Phone (314) 996-3800

915 N Grand Blvd
Saint Louis, MO 63106
Phone (314) 289-6434

660 S Euclid Ave
#8115
Saint Louis, MO 63110
Phone (314) 362-7395

1044 N Mason Rd
Saint Louis, MO 63141

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

Interoperability endpoints

  • Direct secure messaging: mwatkins2783628@direct.trinity-health.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 1

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": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1194348540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-996-3880",
            "fax_number": "314-996-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N MASON RD",
            "address_2": "DEPT OTOLARYNGOLOGY, STE L10",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416431",
            "telephone_number": "314-996-3880",
            "fax_number": "314-996-8610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 N Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631061621",
            "country_code": "US",
            "telephone_number": "314-652-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "MARIEL",
        "middle_name": "OLIVIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MO",
            "license": "2025029374",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2025029374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1044 N Mason Rd",
            "address_2": "Dept Otolaryngology, Ste L10",
            "city": "Creve Coeur",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

Verify at the official NPI Registry.