Active NPI
Michael Dylan Watts, CRNA
- Certified Registered Nurse Anesthetist
- Irving, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2022031973
- Practice address
- 6225 N State Highway 161 Ste 200
Irving, TX 75038-2241 - Phone
- (214) 687-0001
- Fax
- (972) 518-2100
- NPI assigned
- Jun 2, 2022
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2022031973 | MO | Primary |
Addresses
Primary practice location
6225 N State Highway 161 Ste 200
Irving, TX 75038-2241
Mailing address
6225 N State Highway 161 Ste 200
Irving, TX 75038-2241
Phone (000) 121-4687
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Mercy Way
Joplin, MO 64804-4524
Phone (417) 556-3729
Hospital & facility affiliations
- Mercy Hospital Joplin
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022031973 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Missouri, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784
203 W Road Mize Rd
Ste 218
Blue Springs, MO 64014
Phone (816) 874-4181
201 W Road Mize Rd
Blue Springs, MO 64014
Phone (816) 228-5900
100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300
1000 Carondelet Dr
Kansas City, MO 64114
Phone (816) 942-4400
6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Irving, TX
- NPI 1396191789
MO, Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Joplin, MO
- NPI 1700112745
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660780800000",
"number": "1942949383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6225 N STATE HIGHWAY 161 STE 200",
"city": "IRVING",
"state": "TX",
"postal_code": "750382241",
"telephone_number": "000-121-4687",
"fax_number": "972-518-2100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6225 N STATE HIGHWAY 161 STE 200",
"city": "IRVING",
"state": "TX",
"postal_code": "750382241",
"telephone_number": "214-687-0001",
"fax_number": "972-518-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "MICHAEL",
"middle_name": "DYLAN",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-02",
"last_updated": "2022-08-18",
"certification_date": "2022-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2022031973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.