JUSTINE ANNISSA-MARIE WATSON (PA-C) – Physician Assistant, NPI 1417330341
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for JUSTINE ANNISSA-MARIE WATSON (PA-C)
12251 S 80th Ave Ste 1520
Palos Heights, IL 604631290
Phone: (708) 923-4200
Fax: (708) 923-4201
Type: Location
4755 OGLETOWN STANTON RD STE 5A43
NEWARK, DE 197182200
Phone: (302) 623-0188
Fax: (302) 733-5640
Type: Mailing
6934 AVIATION BLVD STE B
GLEN BURNIE, MD 210612593
Phone: (443) 949-0814
Type: Location
12251 S 80TH AVE STE 1520
PALOS HEIGHTS, IL 604631290
Phone: (708) 923-4200
Fax: (708) 923-4201
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $630.
Total Amount is formed as General ($630) + Research ($0) + Ownership ($0) = $630.
Last reported payment date: 2024-08-16 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($380).
Total Amount
$630
General + Research + Ownership
Payments
9
Total payment records
General Amount
$630
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Edwards Lifesciences Corporation | $380 |
| Getinge USA Sales, LLC | $155 |
| Baxter Healthcare | $95 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-06-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20161109002095 | I | Physician Assistant | DE | TBD |
| I20240604001486 | I | Physician Assistant | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 33533 | Coronary artery bypass using artery graft, 1 graft | 17 | 17 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 14 | 14 | $0 |
Insurance plans in this area (ZIP 60463)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | DE | |
| - | DE | |
| - | DE | |
| - | PA | |
| Internal Medicine | DE | |
| Physician Assistant | DE | |
| Nurse Practitioner | PA | |
| General Surgery | IL | |
| Diagnostic Radiology | NY | |
| Internal Medicine | NY |
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