Individual provider Active NPI

J. O. Watts, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1538367339
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3900 City Ave
Madison D307
Philadelphia, PA 19131-2908
Phone
(215) 877-7465
Fax
(215) 883-2010
NPI assigned
Jul 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

3900 City Ave
Madison D307
Philadelphia, PA 19131-2908

Mailing address

3900 City Ave
Madison D307
Philadelphia, PA 19131-2908
Phone (215) 877-7465

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080626000098 PA Practitioner - Clinical Social Worker 4486733763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Pittsburgh School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Omni Health Services IncGroup PAC ID 1153571831, 20 clinicians

Practice addresses (Care Compare)

182 Bethlehem Pike
Colmar, PA 18915-9790
Phone (215) 997-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Transition Phase III Past Accepting new patients
Transition Phase III Past Accepting new patients

Organizations & group practices 3

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1538367339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 CITY AVE",
            "address_2": "MADISON D307",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312908",
            "telephone_number": "215-877-7465",
            "fax_number": "215-883-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CITY AVE",
            "address_2": "MADISON D307",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312908",
            "telephone_number": "215-877-7465",
            "fax_number": "215-883-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "J.",
        "middle_name": "O.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.