Individual provider Active NPI

Ronald O Watson, MD

  • Internal Medicine Physician
  • Seattle, WA
National Provider Identifier
1821173162
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00021869 Issued in WA
Practice address
3400 California Ave SW, Ste 300
Seattle, WA 98116
Phone
(206) 320-3399
Fax
(206) 320-5506
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00021869 WA Primary

Addresses

Primary practice location

3400 California Ave SW, Ste 300
Seattle, WA 98116

Mailing address

PO Box 84026
Seattle, WA 98124-8426
Phone (206) 320-3399

Other identifiers 1

IdentifierTypeStateIssuer
1030840MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100316000265 WA Practitioner - Internal Medicine 4587799549 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00021869WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic CurrentSince Apr 1, 2017 Accepting new patients
The Polyclinic PLLC Internal Medicine CurrentSince Apr 1, 2017 Accepting new patients
The Polyclinic PLLC Internal Medicine Current Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

1145 Broadway
Ste 200
Seattle, WA 98122

1145 Broadway
Seattle, WA 98122

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1821173162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84026",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981248426",
            "telephone_number": "206-320-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CALIFORNIA AVE SW, STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98116",
            "telephone_number": "206-320-3399",
            "fax_number": "206-320-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "RONALD",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00021869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030840",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.