Individual provider Active NPI

Jeremy Paul Watkins, M.D.

  • Otolaryngology Physician
  • Fort Worth, TX
National Provider Identifier
1780800938
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
M8419 Issued in TX
Practice address
5751 Edwards Ranch Road, Suite 200
Fort Worth, TX 76109
Phone
(817) 332-8848
Fax
(817) 335-2670
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X M8419 TX Primary

Addresses

Primary practice location

5751 Edwards Ranch Road, Suite 200
Fort Worth, TX 76109

Mailing address

P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8450

Other identifiers 3

IdentifierTypeStateIssuer
8G2133OtherTXBCBS
760330807OtherTXTAX ID
M8419OtherTXLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20081217000455 TX Practitioner - Otolaryngology 0345302857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Louisiana State University School of Medicine in New Orleans, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians

Practice addresses (Care Compare)

5751 Edwards Ranch Rd
200 Privia Med GRP N TX
Fort Worth, TX 76109-4116
Phone (817) 332-8848

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.51 of 100Reported as apm
Quality
85.62
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8419TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. Current Accepting new patients
Texas Health Care, P.L.L.C. Otolaryngology CurrentSince Oct 1, 2017 Accepting new patients
Texas Health Care, P.L.L.C. Otolaryngology CurrentSince Oct 1, 2017 Accepting new patients

Locations

5751 Edwards Ranch Rd
Ste 105
Fort Worth, TX 76109

1250 8th Ave
Ste 135
Fort Worth, TX 76104
Phone (817) 332-8848

5751 Edwards Ranch Rd
Ste 200
Fort Worth, TX 76109
Phone (817) 332-8848

2821 Lackland Rd
Ste 300
Ft Worth, TX 76116
Phone (817) 740-8400

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

Interoperability endpoints

  • Direct secure messaging: jeremyb.watkins.p1@direct.thc.nextgenshare.com
  • Direct secure messaging: jeremy.watkins.p1@direct.thc.nextgenshare.com
  • Direct secure messaging: jewatkins@direct.uspi.com

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 3

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1780800938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 EDWARDS RANCH ROAD, SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "817-332-8848",
            "fax_number": "817-335-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "JEREMY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "M8419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8G2133",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "760330807",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "M8419",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.