Jammil Pagaduan Watan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

306661 Issued in CA

Practice address

2401 E Orangeburg Ave Ste 330
Modesto, CA 95355-3396

Phone

(209) 724-6000

NPI assigned

Sep 3, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden Valley Health CentersGroup PAC ID 4183527187, 114 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment Care Compare group NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1205683224
  NPD
• Golden Valley Health Centers

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1093817405
  NPD
• Golden Valley Health Centers

  • PACE Provider Organization
  • Modesto, CA
  • NPI 1598302655
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1487867503
  NPD (past)

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

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1427883115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 PROVIDENCE CT",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953769389",
            "telephone_number": "510-512-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 E ORANGEBURG AVE STE 330",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553396",
            "telephone_number": "209-724-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATAN",
        "first_name": "JAMMIL",
        "middle_name": "PAGADUAN",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia Washington
• Monique Faye Washington
• Tyler L Washington
• Lawrence Eugene Waspe, MD
• Caila Marie Wasson, FNP
• Jennifer Nora Waters, MA, ATR, LPCC, LMHC
• Jordan Phillip Waters, LICENSED PCC
• Nathan Watkins Woolbright
• Ashley Watkins
• Judy Ann Watkins

• Physical Therapist in Modesto, CA
• Providers in Modesto, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.