Individual provider Active NPI

Anna K Watson, PA

  • Physician Assistant
  • Bloomfield Hills, MI
National Provider Identifier
1366525842
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002980 Issued in MI
Practice address
2770 Mackintosh LN
B1 Floor University Hospital Recp Emergency
Bloomfield Hills, MI 48302-0933
Phone
(313) 743-8086
NPI assigned
Oct 20, 2006
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 54840 CA
Physician Assistant 363A00000X 5601002980 MI Primary

Addresses

Primary practice location

2770 Mackintosh LN
B1 Floor University Hospital Recp Emergency
Bloomfield Hills, MI 48302-0933

Mailing address

2770 Mackintosh LN
Bloomfield Hills, MI 48302-0933
Phone (313) 743-8086

Other identifiers 1

IdentifierTypeStateIssuer
1158113040OtherMIBCBS IND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20181003002673 CA Practitioner - Physician Assistant 0749255594 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601002980MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ferndale Urgent Care Past Accepting new patients
Action Urgent Care Inc PastSince Jun 6, 2025 Accepting new patients
Degara, PLLC Past Accepting new patients
Michigan Urgent and Primary Care Past Accepting new patients
Clarkston Urgent Care PLC Past Accepting new patients
Michigan Urgent Care Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: awatson523868@direct.hfhs.org
  • FHIR API: https://api.platform.athenahealth.com/24970/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1366525842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 MACKINTOSH LN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020933",
            "telephone_number": "313-743-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 MACKINTOSH LN",
            "address_2": "B1 FLOOR UNIVERSITY HOSPITAL RECP EMERGENCY",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020933",
            "telephone_number": "313-743-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ANNA",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54840",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IND",
            "identifier": "1158113040",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.