Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Kenneth Lee Watson

Individual provider Physical Therapy Assistant · NPI 1699090993

Mr. Kenneth Lee Watson is a Physician Assistant in Philadelphia, Pennsylvania. Qualified in 2016, 10 years ago. Practices with Temple Faculty Practice Plan Inc, a 1,314-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Jersey and Pennsylvania.

Years since qualifying
10
Licensed in
NJ, PA
In the registry since
2010
Specialties on file
3
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3401 N Broad St
Philadelphia, PA 19140-5103
Phone: (215) 707-3133
Fax: (215) 707-3945
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 15032 Poquessing Creek Ln, Philadelphia, PA 19116-1531 — (267) 446-6521

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence MA060559 (PA)
Physical Therapy Assistant Taxonomy 225200000X · Licence TEI002569 (PA)
Physician Assistant Taxonomy 363A00000X · Licence 25MP00409400 (NJ)

Record details

NPI number1699090993
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 30, 2010
Last updated in NPPESMarch 14, 2022
Certification dateMarch 14, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Temple Faculty Practice Plan Inc — 1314 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Philadelphia