DR. BLAKE MOTLEY WATTS M.D.
NPI 1801232723
Family Medicine in Pearland, TX


Quality Rating: 96.32 out of 100 score

NPI Status: Active since May 19, 2013

Contact Information

16100 SOUTH FWY
STE C1/100
PEARLAND, TX
ZIP 77584
Phone: (713) 413-6610
Fax: (713) 413-6601

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  • Individual
  • Female
  • Years of Experience 13
  • Family Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About BLAKE WATTS

This page provides the complete NPI Profile along with additional information for Blake Watts, a primary care provider established in Pearland, Texas with a medical specialization in Family Medicine and more than 13 years of experience. She graduated from University Of Texas Medical School At Houston in 2013. The healthcare provider is registered in the NPI registry with number 1801232723 assigned on May 2013. The practitioner's primary taxonomy code is 207Q00000X with license number Q6124 (TX). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI
1801232723
Provider Name
DR. BLAKE MOTLEY WATTS M.D.
Gender
Female
Entity Type
Individual
Location Address
16100 SOUTH FWY STE C1/100 PEARLAND, TX 77584
Location Phone
(713) 413-6610
Location Fax
(713) 413-6601
Mailing Address
909 FROSTWOOD DR SUITE 1.100 HOUSTON, TX 77024
Mailing Phone
(713) 338-4523
Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduation Year
2013
Is Sole Proprietor?
No
Enumeration Date
05-19-2013
Last Update Date
09-25-2024
Code Navigator

A primary care provider (PCP) like Blake Watts sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
Q6124
License State
TX
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
  • Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
  • Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • Community Premier Bronze 003 (No deductible for PCP, Free Preventive Care, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Premier Bronze 018 (No deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Premier Gold 005 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Premier Gold 021 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Premier Silver 012 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Premier Silver 020 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Select Bronze 016 (No deductible for PCP & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Select Gold 022 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Select Silver 019 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 12 - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with First 4 Primary Care Visits Free - HMO
  • Silver 8 - HMO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Gold Classic - EPO
  • Gold Classic Standard - EPO
  • Gold Elite - EPO
  • Silver Classic - EPO
  • Silver Classic Standard - EPO
  • Silver Simple PCP Saver - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Blake Watts is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Blake Watts is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3476847591

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20160811001341

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Orthotic Devices

  • DME-Orthotic Devices (DF008N)

    Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)

    1 DME suppliers used 11 Medicare Claims 2200 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of influenza virus vaccine

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

This service was performed 16 times for 16 patients

Annual depression screening, 15 minutes

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

This service was performed 13 times for 13 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 46 times for 46 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 53 times for 49 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 85 times for 66 patients

Influenza vaccine split virus, preservative free

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

This service was performed 16 times for 16 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.03 for a new patient copayment and $25.21 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 77584 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $88.15
  • Minimum New Patient Price $57.16
  • Maximum New Patient Price $172.89
  • Average New Patient Copayment $22.03
  • Minimum New Patient Copayment $14.29
  • Maximum New Patient Copayment $43.22

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $100.84
  • Minimum Established Patient Price $18.45
  • Maximum Established Patient Price $141.27
  • Average Established Patient Copayment $25.21
  • Minimum Established Patient Copayment $4.61
  • Maximum Established Patient Copayment $35.31

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 96.32, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 96.32 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 85.05

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Blake Watts is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
MEMORIAL HERMANN HOSPITAL SYSTEM1635 NORTH LOOP WEST
HOUSTON, TX 77008
(713) 448-6796Acute Care Hospitals
MEMORIAL HERMANN SUGAR LAND HOSPITAL17500 W GRAND PARKWAY SOUTH
SUGAR LAND, TX 77479
(281) 725-5000Acute Care Hospitals

Reviews for DR. BLAKE MOTLEY WATTS M.D.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1801232723
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
280143474
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 0 + 1 + 4 + 3 + 4 + 7 + 4 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1801232723 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1346636073 KRYSTAL RONEY-SMITH NP-C
Individual
Nurse Practitioner (Family)16100 SOUTH FWY STE C1/100
PEARLAND, TX 77584
(713) 413-6610
1689193831 GIDGET MICHELLE JOHNSTON CST,CSFA
Individual
Specialist/Technologist, Other (Surgical Assistant)16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-5770
1326084039DR. SAJID RAZA KHAN M.D.
Individual
Emergency Medicine16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-5000
1093273567 SANGEETHA THOMAS
Individual
Registered Nurse (Medical-Surgical)16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-6820
1952421166 SCOTT O'QUINN CONOLY M.D.
Individual
Hospitalist16100 SOUTH FWY
PEARLAND, TX 77584
(281) 929-6184
1972921328 MARYAM ARSHAD
Individual
Emergency Medicine16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-6500
1679929939DR. ROY LEONARD EMANUEL II MD
Individual
Hospitalist16100 SOUTH FWY
PEARLAND, TX 77584
(281) 929-6184
1811505944 INGRID LAUREEN LIMJOCO APRN
Individual
Nurse Practitioner (Critical Care Medicine)16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-5000
1538520218HOSPITAL MEDICINE ASSOCIATES OF TX PA
Organization
Hospitalist16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-6500
1417544057 CATHERINE RESTUA MSN, APRN, FNP-C
Individual
Nurse Practitioner (Family)16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-6832
1205465192 ARULKUMAR GUNASEKARAN ACNP
Individual
Nurse Practitioner (Acute Care)16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-5000
1811586787MEMORIAL PATHOLOGY CONSULTANTS, PA
Organization
Pathology (Anatomic Pathology & Clinical Pathology)16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-5000
1558097832 ENRIQUE SALVANI III RN
Individual
Registered Nurse16100 SOUTH FWY
PEARLAND, TX 77584
(346) 762-9273
1518730803 JANAY LACOUR
Individual
Registered Nurse16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-5000
1407391766MRS. BINCY SAMUEL VARUGHESE AGACNP
Individual
Nurse Practitioner (Acute Care)16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-5000
1215929120 ANN MARTIN APRN
Individual
Nurse Anesthetist, Certified Registered16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-5000
1508466095MRS. RITA G PATEL APRN, AGANCP-BC
Individual
Nurse Practitioner (Acute Care)16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-5000
1710711775 LOGAN VOSS PT, DPT
Individual
Physical Therapist (Sports)16100 SOUTH FWY
PEARLAND, TX 77584
(713) 436-8869
1225424849 ROBERT W BENDER MD
Individual
Hospitalist16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-6941
1508692500 ASHLAN BLOODWORTH CSFA
Individual
Specialist/Technologist, Other (Surgical Assistant)16100 SOUTH FWY
PEARLAND, TX 77584
(713) 413-5000

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1801232723, enumerated in the NPI registry as an "individual" on May 19, 2013

The provider is located at 16100 South Fwy Ste C1/100 Pearland, Tx 77584 and the phone number is (713) 413-6610

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 13 years of experience. She graduated from University Of Texas Medical School At Houston in 2013.

The provider might be accepting Accepts: Aetna CVS Health, Blue Cross and Blue Shield of. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $88.15 with an average copayment of $22.03 for new patient appointments. Established patients should expect a typical charge of $100.84 and an average copayment of 25.21. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Administration of influenza virus vaccine, Annual depression screening, 15 minutes, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes and Influenza vaccine split virus, preservative free.

The practitioner is affiliated to the following hospital(s): MEMORIAL HERMANN HOSPITAL SYSTEM and MEMORIAL HERMANN SUGAR LAND HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on May 19, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.