NPIMap

Individual provider Active NPI

Mark C Watts, MD

  • Neurological Surgery Physician
  • Poughkeepsie, NY
National Provider Identifier
1700913738
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
42756 Issued in CO
Practice address
19 Baker Ave
Suite 301
Poughkeepsie, NY 12601-1359
Phone
(845) 483-5305
Fax
(845) 483-5302
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 42756 CO Primary
Neurological Surgery Physician 207T00000X 286555 NY

Addresses

Primary practice location

19 Baker Ave
Suite 301
Poughkeepsie, NY 12601-1359

Mailing address

19 Bradhurst Ave
Suite 3100N
Hawthorne, NY 10532-2140
Phone (914) 909-9018

Other practice location 1

1182 Troy Schenectady Rd Ste 100
Latham, NY 12110-1000
Phone (518) 713-5400

Other practice location 2

1725 E Boulder St Ste 101
Colorado Springs, CO 80909-5740
Phone (719) 365-7300

Other identifiers 3

IdentifierTypeStateIssuer
08874361MedicaidCO
015560OtherKAISER-COMMERCIAL NUMBER
286555OtherNYNYS LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200325000116 PA Practitioner - Neurosurgery 5890858492 Reassigns benefits to 1 organization
I20250528000776 TX Practitioner - Neurosurgery 5890858492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Stanford University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Native Tribal Health ConsortiumGroup PAC ID 6709780265, 605 clinicians

Practice addresses (Care Compare)

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

Hospital & facility affiliations

  • Alaska Native Medical Center Hospital, Anchorage, AK, CCN 020026

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42756COMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Altoona Regional Health Services, Inc CurrentSince Mar 1, 2020 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Mar 23, 2025 Accepting new patients
Upmc Altoona Regional Health Services, Inc Current Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

1414 9th Ave
Altoona, PA 16602
Phone (814) 949-7621

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1700913738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE",
            "address_2": "SUITE 3100N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-909-9018",
            "fax_number": "914-909-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BAKER AVE",
            "address_2": "SUITE 301",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011359",
            "telephone_number": "845-483-5305",
            "fax_number": "845-483-5302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1182 Troy Schenectady Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Latham",
            "state": "NY",
            "postal_code": "121101000",
            "country_code": "US",
            "telephone_number": "518-713-5400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1725 E Boulder St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809095740",
            "country_code": "US",
            "telephone_number": "719-365-7300",
            "fax_number": "719-365-6094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTS",
        "first_name": "MARK",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2021-12-15",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CO",
            "license": "42756",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "286555",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08874361",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "015560",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "286555",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1182 Troy Schenectady Rd Ste 100",
            "city": "Latham",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121101000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.