Individual provider Active NPI

Elizabeth Watson, PA

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1952073736
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
621 S New Ballas Rd Ste 560a
Saint Louis, MO 63141-8261
Phone
(314) 251-6440
NPI assigned
Sep 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 560a
Saint Louis, MO 63141-8261

Mailing address

621 S New Ballas Rd Ste 560a
Saint Louis, MO 63141-8261
Phone (314) 251-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230127000426 MO Practitioner - Physician Assistant 4688045727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Trauma and General Surgery LLCGroup PAC ID 1658320700, 44 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 560a
Saint Louis, MO 63141-8261
Phone (314) 569-6440

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

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

Organizations & group practices 2

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.

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": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1952073736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 560A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418261",
            "telephone_number": "314-251-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 560A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418261",
            "telephone_number": "314-251-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.