Marie Annette Watson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008091 Issued in MI

Practice address

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

Phone

(734) 712-8676

Fax

(734) 712-3855

NPI assigned

Aug 7, 2015

Last updated

Sep 11, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Marie Annette Herzog Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Iha Health Services Corporation

  dba IHA Canton Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment Care Compare group
• Iha Health Service Corporation

  dba Trinity Health IHA Medical Group OB/GYN Float

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Ypsilanti, MI
  • NPI 1922349307
  NPD
• Pekin Prohealth Inc

  • Family Medicine Physician
  • Pekin, IL
  • NPI 1932150299
  NPD (past)

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

• St Joseph Mercy Hospital

  dba Trinity Heath Ann Arbor Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505088000000",
    "number": "1649656059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 - LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E HURON RIVER DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-8676",
            "fax_number": "734-712-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MARIE",
        "middle_name": "ANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2017-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005540",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "HERZOG",
            "middle_name": "ANNETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Washtenaw Podiatry Group, LLC
• Horace James Watkins Jr.
• Patricia Watkins, RN
• Bradley Watson, MS, AT, ATC
• Jesika Watson, CRNA
• John Watt, MD
• We DO Recover, LLC (1st Step Referral)
• Daron Weatherspoon Sr.
• Sheena Lakay Webb-Jones, LPN
• Laura Weber, CRNA

• Physician Assistant in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (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.