Elyssa Watts, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601011987 Issued in MI

Practice address

1215 E Michigan Ave
Lansing, MI 48912-1896

Phone

(517) 364-1000

NPI assigned

Aug 21, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Vituity - Michigan Em PC

  dba Vituity

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1144892332
  Medicare reassignment

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1730963828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2173 IROQUOIS RD",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641011",
            "telephone_number": "616-490-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121896",
            "telephone_number": "517-364-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2446 Jolly Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Okemos",
            "state": "MI",
            "postal_code": "488643514",
            "country_code": "US",
            "telephone_number": "517-253-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "321 E Harris St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "MI",
            "postal_code": "488131629",
            "country_code": "US",
            "telephone_number": "517-543-1050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3565 S State Rd",
            "address_purpose": "LOCATION",
            "city": "Ionia",
            "state": "MI",
            "postal_code": "488469416",
            "country_code": "US",
            "telephone_number": "616-523-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTS",
        "first_name": "ELYSSA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenton Lee Waterbrook, DO
• Emma Jane Waterstrat
• Lydia Ann Watkins, NP
• Andrea Elizabeth Watson, RN
• Brian Ray Watts, ABOC
• Kimberly Watts
• Priyanka Watwe, D.D.S.
• Waverly Chiropractic Center P.L.L.C.
• Wayne County Physical Therapy, LLC
• Wayne F. Goodrich (Mobility Options of Lansing)

• Physician Assistant in Lansing, MI
• Providers in Lansing, 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 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.