NPIMap

Individual provider Active NPI

Gregory Scott Watkins, PA

  • Physician Assistant
  • Plymouth, MN
National Provider Identifier
1982626362
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9194 Issued in MN
Practice address
2855 Campus Dr
Plymouth, MN 55441-2649
Phone
(763) 577-7179
NPI assigned
Jul 24, 2006
Last updated
Jan 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 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 9194 MN Primary

Addresses

Primary practice location

2855 Campus Dr
Plymouth, MN 55441-2649

Mailing address

2829 University Ave SE Ste 730
Minneapolis, MN 55414-3279
Phone (612) 439-1867

Other identifiers 1

IdentifierTypeStateIssuer
448949700MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gwatkins99507@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20050114000476 MN Practitioner - Physician Assistant 5698724847 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Southwestern Medical School at Dallas, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2855 Campus Dr
Plymouth, MN 55441-2649
Phone (763) 577-7160

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.56
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9194MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ecc Addiction & Toxicology Services LLC CurrentSince Jan 26, 2022 Accepting new patients
Allina Health System CurrentSince Feb 1, 2012 Accepting new patients
Allina Health System CurrentSince Feb 1, 2012 Accepting new patients
NPI 1083910871 Past Accepting new patients

Locations

200 State Ave
Faribault, MN 55021
Phone (507) 334-6451

1175 Nininger Rd
Hastings, MN 55033
Phone (651) 404-1000

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2829 University Ave SE
Ste 730
Minneapolis, MN 55414
Phone (612) 439-1868

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

2250 NW 26th St
Owatonna, MN 55060
Phone (507) 451-3850

2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1982626362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 UNIVERSITY AVE SE STE 730",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143279",
            "telephone_number": "612-439-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 CAMPUS DR",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412649",
            "telephone_number": "763-577-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "448949700",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gwatkins99507@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2855 Campus Dr",
            "city": "Plymouth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554412649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.