Individual provider Active NPI

Marcia G Watson, D.O.

  • Pulmonary Disease Physician
  • Philadelphia, PA
National Provider Identifier
1447458153
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
OS015026 Issued in PA
Practice address
1317 Wolf St # 19
Philadelphia, PA 19148-2934
Phone
(215) 755-5449
Fax
(215) 755-0010
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS015026 PA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X OS015026 PA
Pulmonary Disease Physician 207RP1001X OS015026 PA Primary

Addresses

Primary practice location

1317 Wolf St # 19
Philadelphia, PA 19148-2934

Mailing address

1317 Wolf St # 19
Philadelphia, PA 19148-2934
Phone (215) 755-5449

Other identifiers 1

IdentifierTypeStateIssuer
0276044MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170804001099 PA Practitioner - Pulmonary Disease 5294927059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Rowan University School of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Methodist Associates in Healthcare, IncGroup PAC ID 6406755651, 387 clinicians

Practice addresses (Care Compare)

2301 S Broad St
Philadelphia, PA 19148-3542

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS015026PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Jul 1, 2017 Accepting new patients
Methodist Associates in Healthcare Heart Station PastSince Jul 24, 2022 Accepting new patients
Methodist Associates in Healthcare, Inc PastSince Jul 24, 2022 Accepting new patients
Methodist Hospital Past Accepting new patients

Locations

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161

Organizations & group practices 5

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 1

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447458153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 WOLF ST # 19",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482934",
            "telephone_number": "215-755-5449",
            "fax_number": "215-755-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 WOLF ST # 19",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482934",
            "telephone_number": "215-755-5449",
            "fax_number": "215-755-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MARCIA",
        "middle_name": "G",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS015026",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PA",
            "license": "OS015026",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "OS015026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0276044",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.