Individual provider Active NPI

Michael Richard Watson, P.T.

  • Physical Therapist
  • Dallas, TX
National Provider Identifier
1215287677
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1112043 Issued in TX
Practice address
4801 S Buckner Blvd Ste 200
Dallas, TX 75227-2372
Phone
(214) 381-7700
Fax
(214) 381-7702
NPI assigned
Sep 13, 2012
Last updated
Aug 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1112043 TX Primary

Addresses

Primary practice location

4801 S Buckner Blvd Ste 200
Dallas, TX 75227-2372

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190128002201 TX Practitioner - Physical Therapist in Private Practice 2365626595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1450 E Belt Line Rd
Suite 200
Richardson, TX 75081-4628
Phone (214) 210-4409

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1112043TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Physical Therapy PC Physical Therapist CurrentSince Jan 4, 2019 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Aug 23, 2021 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Aug 23, 2021 Accepting new patients
Buckner Family Medical Association, PA Physical Therapist PastSince May 1, 2004 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

14999 Preston Rd
Ste 108C
Dallas, TX 75254
Phone (214) 231-4154

6029 Forest Ln
Dallas, TX 75230
Phone (469) 872-7548

4401 N Interstate 35
Unit 110
Denton, TX 76207
Phone (940) 483-9020

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

5129 N Garland Ave
Ste 600
Garland, TX 75040
Phone (469) 838-4072

308 Coit Rd
Ste 400
Plano, TX 75075
Phone (469) 573-9606

4709 W Parker Rd
Ste 460
Plano, TX 75093
Phone (469) 440-5420

9613 Coit Rd
Ste 110
Plano, TX 75024
Phone (945) 544-4792

1450 E Belt Line Rd
Ste 200
Richardson, TX 75081
Phone (214) 210-4409

1701 Gateway Blvd
Ste 32
Richardson, TX 75080
Phone (972) 238-2841

210 W Campbell Rd
Richardson, TX 75080
Phone (469) 709-4178

2268 N Lake Shore Dr
Ste 106
Rockwall, TX 75087
Phone (214) 771-7960

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

809 Woodbridge Pkwy
Ste 200
Wylie, TX 75098
Phone (469) 299-5803

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1215287677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 S BUCKNER BLVD STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752272372",
            "telephone_number": "214-381-7700",
            "fax_number": "214-381-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MICHAEL",
        "middle_name": "RICHARD",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-13",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1112043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.