Individual provider Active NPI

Rachel Wynne Watson, M.D.

  • Pediatrics Physician
  • Huntington Beach, CA
National Provider Identifier
1639532567
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A152540 Issued in CA
Practice address
17742 Beach Blvd Ste 240
Huntington Beach, CA 92647-6835
Phone
(714) 842-0444
Fax
(714) 842-8444
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A152540 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

17742 Beach Blvd Ste 240
Huntington Beach, CA 92647-6835

Mailing address

17742 Beach Blvd Ste 240
Huntington Beach, CA 92647-6835
Phone (714) 842-0444

Other practice location 1

505 S Main St
Suite 525
Orange, CA 92868-4509
Phone (714) 456-5631

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190909002556 CA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 1951656883 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A152540CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Specialists of Orange County CurrentSince Jul 1, 2019 Accepting new patients
University of California Irvine Past Accepting new patients
Coastal Kids, a Professional Medical Corporation Pediatrics Past Accepting new patients

Locations

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

1310 W Stewart Dr
Ste 212
Orange, CA 92868
Phone (714) 543-8911

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1639532567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17742 BEACH BLVD STE 240",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476835",
            "telephone_number": "714-842-0444",
            "fax_number": "714-842-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17742 BEACH BLVD STE 240",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476835",
            "telephone_number": "714-842-0444",
            "fax_number": "714-842-8444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S Main St",
            "address_2": "Suite 525",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684509",
            "country_code": "US",
            "telephone_number": "714-456-5631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "RACHEL",
        "middle_name": "WYNNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A152540",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.