Individual provider Active NPI

David Ernesto Simon, APRN

  • Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1003625062
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11044982 Issued in FL
Practice address
10794 Pines Blvd Ste 202
Pembroke Pines, FL 33026-3920
Phone
(954) 589-5958
Fax
(954) 589-5785
NPI assigned
Jan 4, 2025
Reactivated
Nov 26, 2025
Last updated
May 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11044982 FL Primary
Nurse Practitioner 363L00000X 016395 CT
Registered Nurse 163W00000X RN95262723 CA
Registered Nurse 163W00000X RN9516152 FL
Registered Nurse 163W00000X 213330 CT

Addresses

Primary practice location

10794 Pines Blvd Ste 202
Pembroke Pines, FL 33026-3920

Mailing address

21301 Powerline Rd Ste 106
Boca Raton, FL 33433-2389
Phone (866) 550-2212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260514003418 FL Practitioner - Nurse Practitioner 4183193576 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
The Clinicians, LLCGroup PAC ID 7214154509, 51 clinicians

Practice addresses (Care Compare)

21301 Powerline Rd
Suite 106
Boca Raton, FL 33433-2389
Phone (866) 550-2212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN95262723CAMDRegistered Nurse
213330CTMDRegistered Nurse
RN9516152FLMDRegistered Nurse
016395CTMDNurse Practitioner
11044982FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beepermd Medical Group Florida LLC Current Accepting new patients
Medica One Health LLC PastSince Oct 2, 2022 Accepting new patients

Locations

21301 Powerline Rd
Ste 106
Boca Raton, FL 33433
Phone (866) 550-2212

10970 Cross Creek Blvd
Tampa, FL 33647
Phone (813) 369-5969

10970 Cross Creek Blvd
Ste D
Tampa, FL 33647
Phone (813) 369-5969

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JFAJCD/Endpoint/JFAJCD

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1735948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1003625062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21301 POWERLINE RD STE 106",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334332389",
            "telephone_number": "866-550-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10794 PINES BLVD STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263920",
            "telephone_number": "954-589-5958",
            "fax_number": "954-589-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "DAVID",
        "middle_name": "ERNESTO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-04",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "deactivation_date": "2025-02-04",
        "reactivation_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11044982",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "016395",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN95262723",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9516152",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "213330",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.