NPIMap

Individual provider Active NPI

John Michael Watson, M.D.

  • Surgery Physician
  • Reno, NV
National Provider Identifier
1619039245
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
8648 Issued in NV
Practice address
75 Pringle Way
Suite 1002
Reno, NV 89502-1464
Phone
(775) 323-7500
Fax
(775) 789-9208
NPI assigned
Dec 13, 2006
Last updated
Jan 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 8648 NV Primary
Trauma Surgery Physician 2086S0127X 8648 NV
Surgical Critical Care Physician 2086S0102X 8648 NV

Addresses

Primary practice location

75 Pringle Way
Suite 1002
Reno, NV 89502-1464

Mailing address

75 Pringle Way
Suite 1002
Reno, NV 89502-1464
Phone (775) 323-7500

Other identifiers 5

IdentifierTypeStateIssuer
1619039245MedicaidNV
002016418MedicaidNV
880341656OtherNVGOMEZ, KOZAR, MCELREATH, AND SMITH PROFESSIONAL CORPORATION
BS249YOtherNVMEDICARE PTAN
0020050120OtherNVRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20040928000436 NV Practitioner - General Surgery 4789653668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Nevada School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

10101 Double R Blvd
Reno, NV 89521-5931
Phone (775) 982-7878

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-4000

75 Pringle Way
Reno, NV 89502-1464

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
79.09
Promoting interoperability
100
Improvement activities
40
Cost
71.43

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8648NVMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince Jan 1, 2015 Accepting new patients
Community Care Services LLC CurrentSince Jan 1, 2015 Accepting new patients
Community Care Services LLC Trauma Surgery Current Accepting new patients
Gomez Kozar McElreath Smith Surgery CurrentSince Aug 1, 2012 Accepting new patients
Renown Regional Medical Center Past Accepting new patients
South Lyon Health Center, Inc. Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Mt Grant General Hospital Past Accepting new patients

Locations

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

75 Pringle Way
Ste 1002
Reno, NV 89502
Phone (702) 323-7500

75 Pringle Way
Ste 606
Reno, NV 89502
Phone (702) 329-3315

Interoperability endpoints

  • Direct secure messaging: jwatson1238@direct.renown.org

Organizations & group practices 9

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 11

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1619039245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PRINGLE WAY",
            "address_2": "SUITE 1002",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021464",
            "telephone_number": "775-323-7500",
            "fax_number": "775-789-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PRINGLE WAY",
            "address_2": "SUITE 1002",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021464",
            "telephone_number": "775-323-7500",
            "fax_number": "775-789-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "8648",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NV",
            "license": "8648",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NV",
            "license": "8648",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619039245",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002016418",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOMEZ, KOZAR, MCELREATH, AND SMITH PROFESSIONAL CORPORATION",
            "identifier": "880341656",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BS249Y",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "0020050120",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.