Mark Adam Watson, D.O. – Family Medicine Physician

Key facts

NPI: 1548554157
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: 125-059143 (IL)
Practice address: 3231 Euclid Ave
5TH Floor
Berwyn, IL 60402-3471
Phone: (708) 783-2000
Fax: (708) 783-3656
NPI assigned: Jun 1, 2011
Sex: Male
Sole proprietor: No

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.

Natarajan Medical Group of Illinois, PC Hospice and Palliative Medicine (Family Medicine) Physician · Rosemont, IL · NPI 1639430861

Medicare reassignment Care Compare group NPD IL

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Seasons Hospice, LLC Community Based Hospice Care Agency · Rosemont, IL · NPI 1700889656

Care Compare affiliation Hospice
Swedish Covenant Health General Acute Care Hospital · Chicago, IL · NPI 1831151257

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Family Practice
Education: Other, 2011
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Natarajan Medical Group of Illinois PC (14 clinicians)

Practice addresses (Care Compare)

606 Potter Rd
Des Plaines, IL 60016-5337
Phone (847) 759-9449

Hospital & facility affiliations

Accentcare Hospice & Palliative Care of Illinois Hospice · Rosemont, IL · CCN 141582
Swedish Hospital Hospital · Chicago, IL · CCN 140114

Merit-based Incentive Payment System (MIPS)

Final score: 84.08 of 100 (group)
Quality: 58.48
Improvement activities: 40
Cost: 68.97

Medicare participation

Medicare fee-for-service enrollment: Enrolled in IL
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20150914000352	IL	Practitioner - Family Practice Practitioner - Other (Physician)	5698998912	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy

State licenses

License	State	Type	Specialty
125-059143	IL	MD	Family Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
Natarajan Medical Group of Illinois, PC		Current since Aug 1, 2015	Accepting new patients

Locations

606 Potter Rd
Des Plaines, IL 60016
Phone (800) 570-8809

6400 Shafer Ct
Ste 300
Rosemont, IL 60018
Phone (800) 570-8809

17855 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 201-3800

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	125-059143	IL	Yes

Addresses

Primary practice location

3231 Euclid Ave
5TH Floor
Berwyn, IL 60402-3471

Mailing address

3231 Euclid Ave
5TH Floor
Berwyn, IL 60402-3471
Phone (708) 783-2000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 10, 2013.

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1548554157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE",
            "address_2": "5TH FLOOR",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023471",
            "telephone_number": "708-783-2000",
            "fax_number": "708-783-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE",
            "address_2": "5TH FLOOR",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023471",
            "telephone_number": "708-783-2000",
            "fax_number": "708-783-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MARK",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125-059143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

All providers in Berwyn, IL · Family Medicine Physician in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.