NPIMap

Individual provider Active NPI

Deetu Kadambi Simh, M.D.

  • Nephrology Physician
  • Worcester, MA
National Provider Identifier
1073704425
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
277304 Issued in MA
Practice address
123 Summer St Ste 685N
Worcester, MA 01608-1216
Phone
(508) 363-6008
Fax
(855) 786-5369
NPI assigned
Aug 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35.099745 OH
Nephrology Physician 207RN0300X 277304 MA Primary
Internal Medicine Physician 207R00000X PG PERMIT 81581 AZ

Addresses

Primary practice location

123 Summer St Ste 685N
Worcester, MA 01608-1216

Mailing address

123 Summer St # 685N
Worcester, MA 01608-1216
Phone (508) 363-6008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190307001702 MA Practitioner - Nephrology 0345396370 Reassigns benefits to 2 organizations
I20191021002435 CT Practitioner - Nephrology 0345396370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Mass NephrologyGroup PAC ID 2466834742, 4 clinicians

Practice addresses (Care Compare)

123 Summer St
685N
Worcester, MA 01608-1216
Phone (508) 363-6008

320 Pomfret St
Putnam, CT 06260-1836
Phone (508) 363-6008

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
PG PERMIT 81581AZMDInternal Medicine Physician
277304MAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Mass Nephrology Nephrology CurrentSince Jul 1, 2022 Accepting new patients

Locations

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

100 South St
Ste 208
Southbridge, MA 01550
Phone (508) 764-6356

100 Wason Ave
Ste 200
Springfield, MA 01107
Phone (413) 773-5797

123 Summer St
Ste 685N
Worcester, MA 01608
Phone (508) 363-6008

123 Summer St
#685N
Worcester, MA 01608
Phone (508) 363-6008

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Organizations & group practices 2

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 9

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": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1073704425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST # 685N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-6008",
            "fax_number": "508-363-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST STE 685N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-6008",
            "fax_number": "855-786-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMH",
        "first_name": "DEETU",
        "middle_name": "KADAMBI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35.099745",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "277304",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "PG PERMIT 81581",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.