Individual provider Active NPI

Mary Tally Watson, OD

  • Optometrist
  • Madison, AL
National Provider Identifier
1467445965
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S817TA165 Issued in AL
Practice address
7880 Old Madison Pike
Madison, AL 35758-1435
Phone
(256) 772-8711
Fax
(256) 772-8738
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S817TA165 AL Primary

Addresses

Primary practice location

7880 Old Madison Pike
Madison, AL 35758-1435

Mailing address

15933 Clayton Rd
Suite 201
Ballwin, MO 63011-2172
Phone (636) 200-4393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040823000852 AL Practitioner - Optometry 1254305527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecare Associates, Inc.Group PAC ID 0749254001, 52 clinicians

Practice addresses (Care Compare)

7880 Old Madison Pike
Madison, AL 35758-1435
Phone (256) 772-8711

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as apm
Quality
82.81
Promoting interoperability
83.07
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Associates, Inc. Optometrist CurrentSince May 10, 2017 Accepting new patients
Eyecare Associates, Inc. Optometrist Current Accepting new patients
Eyecare Associates, Inc. CurrentSince May 10, 2017 Accepting new patients
Eyecare Associates, Inc. Past Accepting new patients

Locations

210 Bob Wallace Ave SW
Huntsville, AL 35801
Phone (256) 539-3454

7105 Bailey Creek Cir SE
Huntsville, AL 35802
Phone (256) 772-8711

7880 Old Madison Pike
Madison, AL 35758
Phone (256) 772-8711

15933 Clayton Rd
Ste 201
Ballwin, MO 63011

Interoperability endpoints

  • Direct secure messaging: mwatson@direct.eyecare-partners.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1467445965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15933 CLAYTON RD",
            "address_2": "SUITE 201",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112172",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7880 OLD MADISON PIKE",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581435",
            "telephone_number": "256-772-8711",
            "fax_number": "256-772-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MARY",
        "middle_name": "TALLY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S817TA165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.