Individual provider Active NPI

Grace Watson, NP

  • Nurse Practitioner
  • San Carlos, CA
National Provider Identifier
1235507245
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95009330 Issued in CA
Practice address
301 Industrial Rd
San Carlos, CA 94070
Phone
(650) 596-4240
NPI assigned
Sep 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95009330 CA Primary

Addresses

Primary practice location

301 Industrial Rd
San Carlos, CA 94070

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (650) 596-4240

Other practice location 1

285 Governor St
Providence, RI 02906-3237
Phone (401) 228-3490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20220125002746 CT Practitioner - Nurse Practitioner 1254635170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Planned Parenthood of Southern New England IncGroup PAC ID 3173436730, 41 clinicians

Practice addresses (Care Compare)

1229 Albany Ave
Hartford, CT 06112-2132
Phone (860) 728-0203

345 Whitney Ave
New Haven, CT 06511-2348
Phone (203) 503-0450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95009330CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Southern New England, Inc. CurrentSince Oct 21, 2021 Accepting new patients

Locations

1229 Albany Ave
Hartford, CT 06112
Phone (860) 524-9820

345 Whitney Ave
New Haven, CT 06511
Phone (203) 503-0450

Organizations & group practices 1

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": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1235507245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "650-596-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 INDUSTRIAL RD",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "94070",
            "telephone_number": "650-596-4240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "285 Governor St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029063237",
            "country_code": "US",
            "telephone_number": "401-228-3490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "GRACE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95009330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

Verify at the official NPI Registry.