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Active NPI 1073554150 Individual Practitioner Male Practitioner

Wallace Carlisle Watson , PA

Physician Assistant • Cuba, NY

Professional Overview & Biography Verified Profile Summary

Wallace Watson, PA is a registered healthcare professional specializing in Physician Assistant in Cuba, NY. Practice services are available at 21 E MAIN ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

21 E Main St

Cuba, NY 147271205

Telephone 5859684357
Fax 5859684356
Associated Practice Facility / Clinic
🏢 Cuba Care Facility NPI 1639342736

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Cuba, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 3.0 Yrs
State Avg: 12.0 Yrs
Regional Practice Density
5 Specialists

Practicing in Cuba, NY (15701 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License NY 001255

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

General Practice

NUCC Taxonomy Code: 208D00000X

State License NY 0012551

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
01531593 (NY)
Commercial Insurance / Payer ID Iha
0490352 (NY)
Commercial Insurance / Payer ID Univera
00010257702
Commercial Insurance / Payer ID Railroad Medicare
407113852
Commercial Insurance / Payer ID Bcwny
000508499002 (NY)
Commercial Insurance / Payer ID Ghi
2598491

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active May 28, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location May 28, 2013

Registered at 21 E MAIN ST, CUBA, NY 147271205 (Tel: 5859684357)

📍
Updated Business Mailing Address May 28, 2013

Registered at 2211 W STATE ST, SUITE 121, OLEAN, NY 147601951 (Tel: 7163722708)

👤
Provider Name / Credentials Updated May 28, 2013

Recorded as WALLACE WATSON, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 28, 2013

General Practice (License #0012551 in NY)

🟢
Initial NPI Registration & Enumeration June 09, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1073554150
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 09, 2006
Last Update: May 28, 2013
Sole Proprietor: No

Mailing Address

2211 W State St, Suite 121

Olean, NY 147601951

Phone: 7163722708

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.