Marysia Watson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12377655-1204 Issued in UT

Practice address

4624 S Holladay Blvd
Salt Lake City, UT 84117-7054

Phone

(801) 277-2682

NPI assigned

May 28, 2018

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

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Family Practice

Education

Midwestern University, Chicago College of Osteopathic Med, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Olympus ClinicGroup PAC ID 8921991506, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Medical Center Hospital, Murray, UT, CCN 460010
• St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marysia.watson@27705477693444.direct.elationemr.com

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.

• Olympus Clinic

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1508810508
  Medicare reassignment Care Compare group NPD

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

• Ihc Health Services, Inc.

  dba Intermountain Health Intermountain Medical Center

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Northern Utah Healthcare Corporation

  dba St. Mark'S Hospital

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation

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

{
    "created_epoch": "1527465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1811488695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 S HOLLADAY BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841177054",
            "telephone_number": "801-277-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 S HOLLADAY BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841177054",
            "telephone_number": "801-277-2682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MARYSIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-28",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "12377655-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dayron Watson
• Emily Watson, APRN
• Hillary J Watson, APRN
• Kendra Vivian Watson, DO
• Marianne E Watson, CSW
• Melissa G. Watson
• Micah McBride Watson
• Michael Jay Watson, D.D.S
• Rachel Sage Watson
• Sharlene K Watson, APRN

• Family Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.