Active NPI
Ronald O Watson, MD
- Internal Medicine Physician
- Seattle, WA
National Provider Identifier
1821173162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD00021869
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1030840 | Medicaid | WA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00021869 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Polyclinic | Current | Accepting new patients | |
| The Polyclinic PLLC | Internal Medicine | Current | 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
- 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.
-
- Ambulatory Surgical Clinic/Center
- Seattle, WA
- NPI 1073944039
-
- Durable Medical Equipment & Medical Supplies
- Tacoma, WA
- NPI 1831411487
Internal Medicine
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.