Individual provider Active NPI

Michael Robert Watson, DPT

  • Physical Therapist
  • Hazelwood, MO
National Provider Identifier
1356791628
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT026606 Issued in PA
Practice address
463 Lynn Haven LN
Hazelwood, MO 63042-1808
Phone
(314) 731-0448
NPI assigned
Jun 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT021678 OH
Physical Therapist 225100000X 2016020586 MO
Physical Therapist 225100000X 009303 KY
Physical Therapist 225100000X PT-2025-0093 NM
Physical Therapist 225100000X 30368 MD
Physical Therapist 225100000X 054129 NY
Physical Therapist 225100000X 1406689 TX
Physical Therapist 225100000X PT026606 PA Primary

Addresses

Primary practice location

463 Lynn Haven LN
Hazelwood, MO 63042-1808

Mailing address

169 Madison Ave
New York, NY 10016-5101
Phone (412) 335-7286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009303KYMDPhysical Therapist
30368MDMDPhysical Therapist
2016020586MOMDPhysical Therapist
PT-2025-0093NMMDPhysical Therapist
054129NYMDPhysical Therapist
PT021678OHMDPhysical Therapist
1406689TXMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: michael.r.watson@upmcdirect.com

NPI Registry JSON

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1356791628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165101",
            "telephone_number": "412-335-7286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 LYNN HAVEN LN",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421808",
            "telephone_number": "314-731-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-17",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT021678",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2016020586",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "009303",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT-2025-0093",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30368",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054129",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1406689",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT026606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazelwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.