Active NPI
Stephen Simeon, LAC
- Acupuncturist
- Deer Park, NY
National Provider Identifier
1043820459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 006202-1
- Practice address
- 2011 Deer Park Ave
Deer Park, NY 11729-2733 - Phone
- (646) 822-3322
- NPI assigned
- Aug 1, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 006202-1 | NY | Primary |
Addresses
Primary practice location
2011 Deer Park Ave
Deer Park, NY 11729-2733
Mailing address
19905 112TH Ave
Saint Albans, NY 11412-2107
Phone (929) 231-0350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006202-1 | Other | NY | NEW YORK STATE OFFICE OF PROFESSIONAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006202-1 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596240000000",
"number": "1043820459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19905 112TH AVE",
"city": "SAINT ALBANS",
"state": "NY",
"postal_code": "114122107",
"telephone_number": "929-231-0350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2011 DEER PARK AVE",
"city": "DEER PARK",
"state": "NY",
"postal_code": "117292733",
"telephone_number": "646-822-3322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMEON",
"first_name": "STEPHEN",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-01",
"last_updated": "2020-08-01",
"certification_date": "2020-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "006202-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE OFFICE OF PROFESSIONAL",
"identifier": "006202-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Deer Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.