Active NPI
Mary E. Watson, M. D.
- Family Medicine Physician
- Sioux Falls, SD
National Provider Identifier
1962474031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1982
- Practice address
- 1115 E 20TH St
Sioux Falls, SD 57105-1013 - Phone
- (605) 575-1616
- Fax
- (605) 367-7157
- NPI assigned
- Feb 3, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1982 | SD | Primary |
Addresses
Primary practice location
1115 E 20TH St
Sioux Falls, SD 57105-1013
Mailing address
1115 E 20TH St
Sioux Falls, SD 57105-1013
Phone (605) 575-1616
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 777868600 | Medicaid | MN | |
| 5607050 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Sanford School of Medicine of University of South Dakota, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1115 E 20TH St
Sioux Falls, SD 57105-1013
Phone (605) 339-1783
Hospital & facility affiliations
- Avera McKennan Hospital & University Health Center
- Sanford Canton-Inwood Medical Center - Cah
- Sanford Usd Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Sioux Falls | Current | Accepting new patients |
Locations
521 N Main Ave
Ste 100
Sioux Falls, SD 57104
Phone (605) 367-8029
Interoperability endpoints
- mary.watson@centerforfamilymedicine.eclinicaldirectplus.com
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.
-
- Family Medicine Physician
- Sioux Falls, SD
- NPI 1164493672
-
- Federally Qualified Health Center (FQHC)
- Sioux Falls, SD
- NPI 1932295888
Hospital & facility affiliations 29
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1154531630
-
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1184834764
-
- Endocrinology, Diabetes & Metabolism Physician
- Sioux Falls, SD
- NPI 1396711016
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1962474031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 E 20TH ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051013",
"telephone_number": "605-575-1616",
"fax_number": "605-367-7157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 E 20TH ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051013",
"telephone_number": "605-575-1616",
"fax_number": "605-367-7157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "MARY",
"middle_name": "E.",
"credential": "M. D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-03",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SD",
"license": "1982",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "777868600",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5607050",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.
- 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.