Individual provider Active NPI

Kelly A. Watson, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1942529516
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA64659 Issued in CA
Practice address
127 S San Vicente Blvd Ste A3100
Los Angeles, CA 90048-3311
Phone
(310) 423-3851
Fax
(310) 423-3522
NPI assigned
May 21, 2010
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.005988RX OH
Physician Assistant 363A00000X PA64659 CA Primary

Addresses

Primary practice location

127 S San Vicente Blvd Ste A3100
Los Angeles, CA 90048-3311

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513
Phone (104) 233-8513

Other practice location 1

452 W 10th Ave
Columbus, OH 43210-1240
Phone (614) 293-6638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191121001908 OH Practitioner - Physician Assistant 7911167275 Reassigns benefits to 1 organization
I20241211003961 CA Practitioner - Physician Assistant 7911167275 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA64659CAMDPhysician Assistant
50.005988RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Carmel Healthproviders Two LLC Physician Assistant CurrentSince Jul 11, 2022 Accepting new patients
California Cardiovascular and Thoracic Surgeons CurrentSince Jan 27, 2026 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Dec 2, 2024 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Dec 2, 2024 Accepting new patients

Locations

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

168 N Brent St
Ste 508
Ventura, CA 93003
Phone (805) 218-0122

127 S San Vicente Blvd
Ste A3100
West Hollywood, CA 90048
Phone (310) 423-3851

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

6150 E Broad St
Columbus, OH 43213
Phone (614) 546-4400

Interoperability endpoints

  • Direct secure messaging: kwatson1782317@direct.trinity-health.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1942529516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513",
            "telephone_number": "104-233-8513",
            "fax_number": "310-423-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S SAN VICENTE BLVD STE A3100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900483311",
            "telephone_number": "310-423-3851",
            "fax_number": "310-423-3522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "452 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101240",
            "country_code": "US",
            "telephone_number": "614-293-6638",
            "fax_number": "614-293-2867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KELLY",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-21",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005988RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.