Active NPI
Renee Simone, APRN, LICSW, LADC I
- Primary Care Nurse Practitioner
- Chicopee, MA
National Provider Identifier
1053497206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 7234
- Practice address
- 71 Mary St
Chicopee, MA 01020-1139 - Phone
- (413) 536-1918
- Fax
- (413) 536-8078
- NPI assigned
- Oct 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1181 | MA | |
| Clinical Social Worker | 1041C0700X | 111795 | MA | |
| Primary Care Nurse Practitioner | 363LP2300X | MS1125839N | MA | |
| Primary Care Nurse Practitioner | 363LP2300X | 7234 | CT | Primary |
Addresses
Primary practice location
71 Mary St
Chicopee, MA 01020-1139
Mailing address
71 Mary St Ste 1802
Chicopee, MA 01020-1139
Phone (919) 793-6862
Other practice location 1
281 Main St
East Hartford, CT 06118-1823
Phone (860) 569-5900
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2197528 | Other | MA | CIGNA |
| 1036490 | Other | MA | NHP |
| 861096515 | Other | MA | AETNA |
| P08297 | Other | MA | BC/BS |
| 1053497206 | Medicaid | CT | |
| 1853171 | Medicaid | MA | |
| 726247000 | Other | MA | MAGELLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
71 Mary St
Chicopee, MA 01020-1139
Phone (919) 793-6862
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7234 | CT | MD | Primary Care Nurse Practitioner |
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.
-
- Clinical Social Worker
- Chicopee, MA
- NPI 1831359603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559088000000",
"number": "1053497206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 MARY ST STE 1802",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010201139",
"telephone_number": "919-793-6862",
"fax_number": "413-315-8068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 MARY ST",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010201139",
"telephone_number": "413-536-1918",
"fax_number": "413-536-8078"
}
],
"practiceLocations": [
{
"address_1": "281 Main St",
"address_purpose": "LOCATION",
"city": "East Hartford",
"state": "CT",
"postal_code": "061181823",
"country_code": "US",
"telephone_number": "860-569-5900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMONE",
"first_name": "RENEE",
"credential": "APRN, LICSW, LADC I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-31",
"last_updated": "2019-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "1181",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "111795",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MA",
"license": "MS1125839N",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CT",
"license": "7234",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2197528",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "1036490",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "861096515",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "P08297",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1053497206",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1853171",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "726247000",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicopee, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.