Individual provider Active NPI

Justin Watkins, MD

  • Family Medicine Physician
  • Gilbert, AZ
National Provider Identifier
1306372909
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
66347 Issued in AZ
Practice address
155 E Warner Rd
Gilbert, AZ 85296-3082
Phone
(480) 649-6600
Fax
(480) 649-6700
NPI assigned
May 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 28508 FL
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 66347 AZ Primary

Addresses

Primary practice location

155 E Warner Rd
Gilbert, AZ 85296-3082

Mailing address

155 E Warner Rd
Gilbert, AZ 85296-3082
Phone (480) 649-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220823001115 AZ Practitioner - Family Practice 9931582004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

155 E Warner Rd
Gilbert, AZ 85296-3082
Phone (480) 649-6600

2225 W Southern Ave
Suite a
Mesa, AZ 85202-4716
Phone (623) 888-3502

Hospital & facility affiliations

  • Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
  • Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
  • Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66347AZMDFamily Medicine Physician
28508FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC CurrentSince Aug 15, 2022 Accepting new patients
Banner Primary Care Physicians Arizona LLC Multi-Specialty Current Accepting new patients
Banner Primary Care Physicians Arizona LLC Multi-Specialty CurrentSince Aug 15, 2022 Accepting new patients

Locations

155 E Warner Rd
Gilbert, AZ 85296
Phone (480) 649-6600

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

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 3

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": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1306372909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 E WARNER RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963082",
            "telephone_number": "480-649-6600",
            "fax_number": "480-649-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E WARNER RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963082",
            "telephone_number": "480-649-6600",
            "fax_number": "480-649-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2023-05-12",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "28508",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "66347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.