Tyrell Jonathan Simkins, D.O., PH.D.
Individual provider Active NPI Neurology Physician · Sacramento, CA
NPI 1013301340 · NPPES record last updated Nov 30, 2021
Key facts
- NPI
- 1013301340
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- 20A15185 (CA)
- Practice address
- 3160 Folsom Blvd Ste 2100
Sacramento, CA 95816-5266 - Phone
- (916) 734-3588
- NPI assigned
- Mar 25, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210812003395 | CA | Practitioner - Neurology | 6901139518 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A15185 | CA | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the Univ of Ca | Multi-Specialty | Current |
Accepting new patients |
| Regents of the Univ of Ca | Multi-Specialty | Current | Accepting new patients |
| Regents of the Univ of Ca | Multi-Specialty | Current |
Accepting new patients |
| County of Sacramento | Multi-Specialty | Current |
Accepting new patients |
| County of Sacramento | Current |
Accepting new patients | |
| Regents of the Univ of Ca | Multi-Specialty | Past | Accepting new patients |
| University of California, Davis | Past | Accepting new patients | |
| Center for Interventional Spine, a Medical Corporation | Past | Accepting new patients |
Locations
3160 Folsom Blvd
Ste 2100
Sacramento, CA 95816
Phone (916) 734-3588
4600 Broadway
#1100
Sacramento, CA 95820
Phone (916) 874-9670
4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313
4600 Broadway
Sacramento, CA 95820
Phone (916) 874-9670
4860 Y St
Ste 3700
Sacramento, CA 95817
Phone (916) 734-3514
4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700
Interoperability endpoints
- tsimkins352596@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician |
2084N0400X | 20A15185 | CA | Yes |
| Neurology Physician | 2084N0400X | DO192558 | OR |
Addresses
Primary practice location
3160 Folsom Blvd Ste 2100
Sacramento, CA 95816-5266
Mailing address
3160 Folsom Blvd Ste 2100
Sacramento, CA 95816-5266
Phone (916) 734-3588
Other practice location 1
3160 Folsom Blvd Ste 2100
Sacramento, CA 95816-5266
Phone (916) 734-3588
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DO192558 | Other | OR | OREGON MEDICAL LICENSE |
| 20A15185 | Other | CA | CALIFORNIA MEDICAL LICENSE |
Other providers in Sacramento, CA
- Consuelo Simental
- Emily Simi
- Martha Lugenia Simien-Lackey
- Charles Simien
- Gregory Simileer
- Michael Simmerman
- Nicola Yvonne Simmersbach
- Amanda Simmonds
- Jessica Simmons-Reynolds
- Andre Simmons
All providers in Sacramento, CA · Neurology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.