Individual provider Active NPI

Christopher Michael Simpson, PA

  • Physician Assistant
  • Salem, OR
National Provider Identifier
1003178336
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015634 Issued in NY
Practice address
890 Oak St SE BLDG a
Salem, OR 97301-3905
Phone
(503) 814-1278
Fax
(503) 814-1071
NPI assigned
Jun 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 015634 NY Primary

Addresses

Primary practice location

890 Oak St SE BLDG a
Salem, OR 97301-3905

Mailing address

890 Oak St SE BLDG a
Salem, OR 97301-3905
Phone (503) 814-1278

Other identifiers 1

IdentifierTypeStateIssuer
03776845MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141222001375 NY Practitioner - Physician Assistant 6709008741 Reassigns benefits to 1 organization
I20181210001925 AZ Practitioner - Physician Assistant 6709008741 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7042AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services PC Emergency Medicine CurrentSince Sep 1, 2018 Accepting new patients
Medhat F Sami MD PC Current Accepting new patients

Locations

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

37000 N Gantzel Rd
San Tan Valley, AZ 85140
Phone (480) 394-4000

1752 Francis Lewis Blvd
Whitestone, NY 11357
Phone (718) 746-9494

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1003178336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 OAK ST SE BLDG A",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013905",
            "telephone_number": "503-814-1278",
            "fax_number": "503-814-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 OAK ST SE BLDG A",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013905",
            "telephone_number": "503-814-1278",
            "fax_number": "503-814-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03776845",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.