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Ili Wathen, PA-C
NPI 1063722577 · Physician Assistant · Waldorf, MD
Ili Wathen, PA-C is a Physician Assistant provider in Waldorf, MD (NPI 1063722577).
Provider details
- NPI number
- 1063722577
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- C0004349 (MD)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3500 Old Washington Rd Ste 201
Waldorf, MD 20602-3238
Phone: (301) 396-2003
Fax: (240) 222-3134
Street-level locationGet directions
Mailing address
11565 Farm Dr
La Plata, MD 20646-5417
Registry dates
- Enumerated
- 2010-10-18
- Last updated
- 2025-07-28
- Certified
- 2025-07-28
Frequently asked questions
- What is Ili Wathen's NPI number?
- Ili Wathen's National Provider Identifier (NPI) is 1063722577, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ili Wathen's specialty?
- Ili Wathen is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Ili Wathen located?
- Ili Wathen's practice location on file with NPPES is 3500 Old Washington Rd Ste 201, Waldorf, MD 20602-3238.
- What is Ili Wathen's phone number?
- The practice phone number listed in the NPPES registry for Ili Wathen is (301) 396-2003.
- Is Ili Wathen's NPI active?
- Yes — Ili Wathen's NPI (1063722577) is active in the NPPES registry as of the last update on 2025-07-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.