NPIMap

Individual provider Active NPI

Thomas K. Watanabe, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Elkins Park, PA
National Provider Identifier
1972532349
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
35-065929 Issued in OH
Practice address
60 Township Line Rd
Elkins Park, PA 19027-2220
Phone
(215) 663-6677
Fax
(215) 663-6265
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 35-065929 OH Primary

Addresses

Primary practice location

60 Township Line Rd
Elkins Park, PA 19027-2220

Mailing address

5501 Old York Rd
Korman 202
Philadelphia, PA 19141-3018
Phone (215) 254-2695

Other identifiers 4

IdentifierTypeStateIssuer
64957608MedicaidKY
0133117MedicaidOH
200241860MedicaidIN
000000012518OtherANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070417000201 PA Practitioner - Physical Medicine and Rehabilitation 6901888569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

60 E Townshipline Rd
Moss Rehab and Physical Medicine
Elkins Park, PA 19027-2220
Phone (215) 663-6677

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-065929OHMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc Physical Medicine & Rehabilitation CurrentSince Dec 13, 2006 Accepting new patients
Einstein Practice Plan Inc CurrentSince Dec 13, 2006 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients
Albert Einstein Medical Center Past Accepting new patients
University Rehabilitation, Inc. Physical Medicine & Rehabilitation Past Accepting new patients

Locations

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

1200 W Tabor Rd
Philadelphia, PA 19141
Phone (215) 456-9470

Interoperability endpoints

  • Direct secure messaging: thomas.watanabe@direct.einstein.edu

Organizations & group practices 6

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 5

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1972532349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "KORMAN 202",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-254-2695",
            "fax_number": "215-456-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 TOWNSHIP LINE RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272220",
            "telephone_number": "215-663-6677",
            "fax_number": "215-663-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "THOMAS",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "35-065929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64957608",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133117",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200241860",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000012518",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins Park, PA

Sources for this page

Verify at the official NPI Registry.