Active NPI
Purabi Simon, DO
- Emergency Medicine Physician
- Newark, NJ
National Provider Identifier
1073566469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 25MB07827200
- Practice address
- 495 North 13TH Street
Newark, NJ 07107-1397 - Phone
- (973) 268-1400
- NPI assigned
- May 18, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 25MB07827200 | NJ | Primary |
Addresses
Primary practice location
495 North 13TH Street
Newark, NJ 07107-1397
Mailing address
66 W Gilbert St
Red Bank, NJ 07701-4918
Phone (732) 212-0060
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0105830 | Medicaid | NJ | |
| 60067341 | Other | NJ | HORIZON NJ HEALTH |
| P00763319 | Other | NJ | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MB07827200 | NJ | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinitas Emergency Solutions PC | Emergency Medicine | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- Elizabeth, NJ
- NPI 1174646244
Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284940800000",
"number": "1073566469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 W GILBERT ST",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077014918",
"telephone_number": "732-212-0060",
"fax_number": "732-212-0061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "495 NORTH 13TH STREET",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071071397",
"telephone_number": "973-268-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "PURABI",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2010-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NJ",
"license": "25MB07827200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0105830",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON NJ HEALTH",
"identifier": "60067341",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00763319",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.