NPIMap

Individual provider Active NPI

Marshall Tredway Watson Jr., MD

  • Neurological Surgery Physician
  • Santa Fe, NM
National Provider Identifier
1568461374
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
39694 Issued in TN
Practice address
465 Saint Michaels Dr
Suite 107
Santa Fe, NM 87505-7670
Phone
(505) 988-3233
NPI assigned
Jul 14, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 39694 TN Primary

Addresses

Primary practice location

465 Saint Michaels Dr
Suite 107
Santa Fe, NM 87505-7670

Mailing address

465 Saint Michaels Dr
Suite 107
Santa Fe, NM 87505-7670

Other identifiers 1

IdentifierTypeStateIssuer
39694OtherTNLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160122001841 NM Practitioner - Neurosurgery 0840227112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

465 Saint Michaels Dr
Suite 107
Santa Fe, NM 87505-7690
Phone (505) 988-3233

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion73
Laminectomy or laminotomy (partial removal of spine bones)60

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39694TNMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital CurrentSince Dec 1, 2015 Accepting new patients
St. Vincent Hospital CurrentSince Dec 1, 2015 Accepting new patients
St Vincent Hospital Current Accepting new patients
Sumner Neurosurgical Associates PLLC Neurological Surgery PastSince Jan 29, 2007 Accepting new patients
Neurosurgical Group of Nashville,PC Neurological Surgery Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

1631 Hospital Dr
Ste 240
Santa Fe, NM 87505
Phone (505) 913-3975

465 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-5287

465 Saint Michaels Dr
Ste 107
Santa Fe, NM 87505
Phone (505) 988-3233

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

Interoperability endpoints

  • Direct secure messaging: mwatson164701@christushealth.direct-ci.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1568461374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 SAINT MICHAELS DR",
            "address_2": "SUITE 107",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 SAINT MICHAELS DR",
            "address_2": "SUITE 107",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057670",
            "telephone_number": "505-988-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MARSHALL",
        "middle_name": "TREDWAY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TN",
            "license": "39694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "39694",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.