Blaine Kenneth Watkins, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2060 Issued in AZ

Practice address

1155 S Power Rd
Suite 102
Mesa, AZ 85206-3715

Phone

(210) 319-8099

NPI assigned

Sep 15, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Tan Eyecare PLCGroup PAC ID 1456420140, 3 clinicians

John N Chrisagis O D P CGroup PAC ID 6406832997, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• John N Chrisagis O D P C

  • Optometrist
  • Tempe, AZ
  • NPI 1992868699
  Medicare reassignment Care Compare group NPD
• San Tan Eyecare PLC

  • Optometrist
  • Gilbert, AZ
  • NPI 1114101136
  Medicare reassignment Care Compare group NPD
• San Tan Eyecare - Paradise Valley, PLLC

  • Optometrist
  • Phoenix, AZ
  • NPI 1124064654
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1962784975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 S POWER RD",
            "address_2": "SUITE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063715",
            "telephone_number": "210-319-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 S POWER RD",
            "address_2": "SUITE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063715",
            "telephone_number": "210-319-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "BLAINE",
        "middle_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-15",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Waterkotte, DPT
• Kathryne Waters, NP
• Bryce Allen Wathan, RBT
• Jerrin Watkins-Ferroni
• Amber R Watkins, RN
• Carmen Watkins
• Christopher Watkins, DDS
• Jimmie Parks Watkins, M.D. PH.D. D.D.S
• Kelli A Watkins, LMT
• Byron Greenberry Watson

• Optometrist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.

Verify at the official NPI Registry.