Active NPI
Kyneisha Watson, PA-C
- Physician Assistant
- Bowie, MD
National Provider Identifier
1518822170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C0010090
- Practice address
- 14999 Health Center Dr Ste 201
Bowie, MD 20716-1087 - Phone
- (301) 262-6797
- NPI assigned
- Dec 17, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0010090 | MD | Primary |
Addresses
Primary practice location
14999 Health Center Dr Ste 201
Bowie, MD 20716-1087
Mailing address
9523 Snead CT
Laurel, MD 20708-3234
Phone (240) 374-3743
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
14201 Laurel Park Dr
Suite 111
Laurel, MD 20707-5203
Phone (301) 820-7204
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0010090 | MD | MD | Physician Assistant |
Organizations & group practices 1
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": "1765929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771804800000",
"number": "1518822170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9523 SNEAD CT",
"city": "LAUREL",
"state": "MD",
"postal_code": "207083234",
"telephone_number": "240-374-3743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14999 HEALTH CENTER DR STE 201",
"city": "BOWIE",
"state": "MD",
"postal_code": "207161087",
"telephone_number": "301-262-6797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "KYNEISHA",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-12-17",
"last_updated": "2026-02-23",
"certification_date": "2026-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0010090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.