SAMUEL WATKINS (PA) – Physician Assistant, NPI 1902869258

SAMUEL WATKINS (PA) is a healthcare provider. based in Dallas, Texas. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. PA01029 (TX). The NPI Number for SAMUEL WATKINS (PA) is 1902869258

Main info

Male
Name
SAMUEL WATKINS (PA)
NPI
1902869258
Phone
(254) 724-2111
Address
PO BOX 847556
Enumeration Date
8 April 2006
Last Update Date
25 January 2022

Contacts

Secure Messaging
swatkins14367@direct.sw.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

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Provider Addresses for SAMUEL WATKINS (PA)

  • Band Box Place, Dallas, Dallas County, Texas, 75244, United States

    DALLAS, TX 752847556

    Phone: (254) 724-2111

    Type: Mailing

  • PO BOX 844658

    DALLAS, TX 752844658

    Phone: (254) 724-2111

    Type: Mailing

  • Baylor Scott & White Medical Center - Temple, 2401, South 31st Street, Temple, Bell County, Texas, 76508, United States

    TEMPLE, TX 765080001

    Phone: (254) 724-2111

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2005-10-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20051026000545IPhysician AssistantTXTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75284)

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Reviews

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Frequently asked questions

How do payers reference SAMUEL WATKINS (PA)?
For SAMUEL WATKINS (PA), use NPI 1902869258 as the unique 10-digit identifier.
Active or inactive — what applies to SAMUEL WATKINS (PA)?
You should see SAMUEL WATKINS (PA) as active in CMS-hosted NPPES data.
What expertise is attributed to SAMUEL WATKINS (PA)?
SAMUEL WATKINS (PA)'s specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
Is SAMUEL WATKINS (PA) located near Dallas?
SAMUEL WATKINS (PA) currently maps to Dallas, Texas in this extract.
Does SAMUEL WATKINS (PA) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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