Kenneth M Simon, D.O.

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

OS7658 Issued in FL

Practice address

4255 Boy Scout Camp
New Smyrna Beach, FL 32168-8896

Phone

(386) 478-1977

NPI assigned

Oct 14, 2005

Last updated

Aug 25, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Institute of Research Medicine and Surgery PA

  dba Cancer Centers of Florida

  • Hematology & Oncology Physician
  • Orlando, FL
  • NPI 1053388538
  NPD (past)
• Florida Institute of Research, Medicine, and Surgery, P.a.

  dba Cancer Centers of Florida

  • Radiation Oncology Physician
  • Orlando, FL
  • NPI 1598054058
  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1073502993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 BOY SCOUT ROAD",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "32168",
            "telephone_number": "386-478-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 BOY SCOUT CAMP",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688896",
            "telephone_number": "386-478-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "KENNETH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "OS7658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254951400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Alexandra Sharp
• Timothy S Shaw, PHD
• Shoreside Medical Center LLC
• Andrew Ryan Shy, DC
• David H Sienkiewicz, RMHCI
• Phillip M Sinaikin, M.D.
• Robert Singleton, HAS
• Kathryn Sirutis, CRNA
• Skin Dermatology and Cosmetic Services, P.a.
• Erin C. Sloan, PA

• Medical Oncology Physician in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Medical Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.