Individual provider Active NPI

Joseph E Watters, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1972958353
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9112435 Issued in FL
Practice address
3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone
(256) 504-4165
NPI assigned
May 4, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.1143 AL
Physician Assistant 363A00000X 9112435 FL Primary

Addresses

Primary practice location

3100 E Fletcher Ave
Tampa, FL 33613-4613

Mailing address

12802 Tampa Oaks Blvd Ste 300
Temple Terrace, FL 33637-1903
Phone (855) 687-0618

Other practice location 1

2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Phone (813) 929-5000

Other practice location 2

13100 Fort King Rd
Dade City, FL 33525-5294
Phone (352) 521-1100

Other practice location 3

2505 US Highway 431
Boaz, AL 35957-5908
Phone (256) 593-8310

Other practice location 4

7050 Gall Blvd
Zephyrhills, FL 33541-1347
Phone (813) 788-0411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20191209001935 FL Practitioner - Physician Assistant 9234416793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.12 of 100Reported as group
Quality
83.29
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.1143ALMDPhysician Assistant
9112435FLMDPhysician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1972958353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12802 TAMPA OAKS BLVD STE 300",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336371903",
            "telephone_number": "855-687-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134613",
            "telephone_number": "256-504-4165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Bruce B Downs Blvd",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335449207",
            "country_code": "US",
            "telephone_number": "813-929-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13100 Fort King Rd",
            "address_purpose": "LOCATION",
            "city": "Dade City",
            "state": "FL",
            "postal_code": "335255294",
            "country_code": "US",
            "telephone_number": "352-521-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2505 US Highway 431",
            "address_purpose": "LOCATION",
            "city": "Boaz",
            "state": "AL",
            "postal_code": "359575908",
            "country_code": "US",
            "telephone_number": "256-593-8310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7050 Gall Blvd",
            "address_purpose": "LOCATION",
            "city": "Zephyrhills",
            "state": "FL",
            "postal_code": "335411347",
            "country_code": "US",
            "telephone_number": "813-788-0411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTERS",
        "first_name": "JOSEPH",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.1143",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9112435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.