Individual provider Active NPI

Lisa Sharee Watts, M.D.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1992926158
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT189115 Issued in PA
Practice address
5500 Wissahickon Ave, Apt. M710C
Philadelphia, PA 19144
Phone
(202) 306-2233
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT189115 PA Primary

Addresses

Primary practice location

5500 Wissahickon Ave, Apt. M710C
Philadelphia, PA 19144

Mailing address

8008 Westpark Dr
MC Lean, VA 22102-3109
Phone (703) 287-1519

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, VA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090908000176 DC Practitioner - Emergency Medicine 5698820116 Reassigns benefits to 2 organizations
I20160418000861 MD Practitioner - Emergency Medicine 5698820116 Reassigns benefits to 1 organization
I20170327002202 VA Practitioner - Emergency Medicine 5698820116 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT189115PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Apr 17, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 3, 2017 Accepting new patients
Commonwealth Emergency Physicians PC Emergency Medicine CurrentSince Jun 1, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 3, 2017 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

2101 E Jefferson St
Ste 6
Rockville, MD 20852

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

9321 Sanger St
Ste 100
Lorton, VA 22079
Phone (703) 922-7631

8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Organizations & group practices 7

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1992926158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8008 WESTPARK DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023109",
            "telephone_number": "703-287-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 WISSAHICKON AVE, APT. M710C",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19144",
            "telephone_number": "202-306-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "LISA",
        "middle_name": "SHAREE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT189115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "14139 Potomac Mills Rd",
            "city": "Woodbridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221924644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.