Individual provider Active NPI

Mariah Helene Simons, PA

  • Physician Assistant
  • Plattsburgh, NY
National Provider Identifier
1013766625
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
032098 Issued in NY
Practice address
75 Beekman St
Plattsburgh, NY 12901-1438
Phone
(518) 561-2000
NPI assigned
May 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 032098-01 NY
Physician Assistant 363A00000X 032098 NY Primary

Addresses

Primary practice location

75 Beekman St
Plattsburgh, NY 12901-1438

Mailing address

108 Split Rock Rd
Hammond, NY 13646-4252
Phone (315) 771-4081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20241108003194 NY Practitioner - Physician Assistant 2668906983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 562-7100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032098NYMDPhysician Assistant
032098-01NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Champlain Valley Physicians Hospital Medical Center Multi-Specialty CurrentSince Sep 29, 2024 Accepting new patients

Locations

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

Interoperability endpoints

  • Direct secure messaging: msimons595735@direct.uvmhealth.org

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1013766625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 SPLIT ROCK RD",
            "city": "HAMMOND",
            "state": "NY",
            "postal_code": "136464252",
            "telephone_number": "315-771-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BEEKMAN ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011438",
            "telephone_number": "518-561-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "MARIAH",
        "middle_name": "HELENE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032098-01",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.