Individual provider Active NPI

Michael Simons, CRNA

  • Certified Registered Nurse Anesthetist
  • Corning, NY
National Provider Identifier
1063830792
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
630215 Issued in NY
Practice address
176 Denison Pkwy E
Corning, NY 14830-2814
Phone
(607) 937-7278
NPI assigned
Mar 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN632747 PA
Certified Registered Nurse Anesthetist 367500000X 630215 NY Primary

Addresses

Primary practice location

176 Denison Pkwy E
Corning, NY 14830-2814

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140620001461 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224252853 Reassigns benefits to 4 organizations
I20141016002511 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224252853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 624-6000

1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 625-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
630215NYMDCertified Registered Nurse Anesthetist
RN632747PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Jun 30, 2014 Accepting new patients
MVHS Inc CurrentSince Mar 13, 2023 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jun 30, 2014 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Sep 9, 2019 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Aug 23, 2014 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
MVHS Inc CurrentSince Mar 13, 2023 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Sep 9, 2019 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

460 Andes Rd
Delhi, NY 13753
Phone (607) 746-0300

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

130 North St
Walton, NY 13856
Phone (607) 865-6541

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Organizations & group practices 8

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1063830792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 DENISON PKWY E",
            "city": "CORNING",
            "state": "NY",
            "postal_code": "148302814",
            "telephone_number": "607-937-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN632747",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "630215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corning, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.