Look up the most recent NPI and PECOS records

Candace Summer Watts

Family Medicine

Allopathic & Osteopathic Physicians

632 Broadway Ph, New York, NY 10012-2614

PECOS Enrollment

Based on the most recent information from CMS, provider Candace Summer Watts does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1225491160
Provider Type
Individual
Full Name
Watts, Candace Summer
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
3/29/2016
Last Updated
2/19/2025

Contact Information

Practice Location

632 Broadway Ph, New York, NY 10012-2614

(800) 731-4254

Unlisted Fax

Mailing Location

1209 Mountain Road Pl NE Ste 5174, Albuquerque, NM 87110-7845

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License MD20221408 New Mexico
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 151459 Alaska
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License MD60852613 Washington
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License DR.0074500 Colorado

Candace Summer Watts

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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