Individual provider Active NPI

Kevin Watson, PA-C

  • Physician Assistant
  • Kansas City, MO
National Provider Identifier
1730635574
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2020008278 Issued in MO
Practice address
4320 Wornall Rd Ste 710
Kansas City, MO 64111-3246
Phone
(816) 932-2700
Fax
(816) 932-2705
NPI assigned
Aug 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-02340 KS
Physician Assistant 363A00000X 083606 IA
Physician Assistant 363A00000X 2020008278 MO Primary

Addresses

Primary practice location

4320 Wornall Rd Ste 710
Kansas City, MO 64111-3246

Mailing address

901 E 104TH St # Ms 400
Kansas City, MO 64131-4517
Phone (816) 932-6433

Other practice location 1

1111 6th Avenue
East Tower, Suite B1
Des Moines, IA 50314-2610
Phone (515) 358-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200417002088 MO Practitioner - Physician Assistant 5496041915 Reassigns benefits to 1 organization
I20230922002051 KS Practitioner - Physician Assistant 5496041915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

4320 Wornall Rd
Suite 710
Kansas City, MO 64111-3246
Phone (816) 932-2700

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100

601 S 169 Hwy
Smithville, MO 64089-9317
Phone (816) 532-3700

601 S US Hwy 169
Smithville, MO 64089-9317
Phone (816) 532-3999

Hospital & facility affiliations

  • St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138
  • Saint Luke'S East Hospital Hospital, Lees Summit, MO, CCN 260216
  • Saint Luke'S South Hospital Hospital, Overland Park, KS, CCN 170185
  • Saint Lukes North Hospital Hospital, Kansas City, MO, CCN 260062

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
76.07
Promoting interoperability
100
Improvement activities
40
Cost
65.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-02340KSMDPhysician Assistant
2020008278MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc CurrentSince May 18, 2020 Accepting new patients
Saint Lukes Physician Group Inc Physician Assistant CurrentSince Aug 22, 2023 Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

901 E 104th St
Ste 400
Kansas City, MO 64131
Phone (816) 502-8752

901 E 104th St
#400S
Kansas City, MO 64131
Phone (816) 502-7117

4320 Wornall Rd
Ste 710
Kansas City, MO 64111
Phone (816) 531-5570

20 NE Saint Lukes Blvd
Ste 300
Lees Summit, MO 64086
Phone (816) 531-4080

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: kwatson389308@direct.saint-lukes.org

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 6

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": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1730635574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST # MS 400",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314517",
            "telephone_number": "816-932-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 WORNALL RD STE 710",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113246",
            "telephone_number": "816-932-2700",
            "fax_number": "816-932-2705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 6th Avenue",
            "address_2": "East Tower, Suite B1",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503142610",
            "country_code": "US",
            "telephone_number": "515-358-0100",
            "fax_number": "515-358-0109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KEVIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02340",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "083606",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2020008278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.