Individual provider Active NPI

Anton Simorov, M.D.

  • Surgery Physician
  • San Antonio, TX
National Provider Identifier
1083020556
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
U9174 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-8900
Fax
(210) 567-5797
NPI assigned
Jul 6, 2014
Last updated
Jun 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X U9174 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190715000653 NE Practitioner - General Surgery 1052530268 Reassigns benefits to 2 organizations
I20240515002534 TX Practitioner - General Surgery 1052530268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1710 E Saunders St
Suite B460
Laredo, TX 78041-5454
Phone (956) 796-2999

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
U9174TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc Surgery CurrentSince Jul 1, 2024 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Jul 1, 2024 Accepting new patients
Faith Regional Physician Services, LLC CurrentSince Aug 8, 2022 Accepting new patients
Faith Regional Physician Services, LLC CurrentSince Aug 8, 2022 Accepting new patients
CHI Health Clinic Specialty, LLC Surgery CurrentSince Jan 1, 2021 Accepting new patients
Regional Employee Assistance Program Inc Surgery Current Accepting new patients

Locations

2620 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-6856

908 N Howard Ave
Ste 108
Grand Island, NE 68803
Phone (308) 381-2224

47452 268 Ave
Ste C
Humphrey, NE 68642
Phone (402) 923-0150

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701
Phone (402) 844-8194

2701 W Norfolk Ave
Norfolk, NE 68701
Phone (402) 844-8158

1700 E Saunders St
Laredo, TX 78041
Phone (956) 206-6971

1710 E Saunders St
Ste B460
Laredo, TX 78041
Phone (956) 794-8720

2005 E Bustamante St
Laredo, TX 78041
Phone (210) 474-0273

Interoperability endpoints

  • Direct secure messaging: anton.simorov.1@1902.direct.athenahealth.com
  • Direct secure messaging: antonsimorov@cneb.allscriptsdirect.net

Organizations & group practices 6

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.

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": "1404604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1083020556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-8900",
            "fax_number": "210-567-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-8900",
            "fax_number": "210-567-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMOROV",
        "first_name": "ANTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-06",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "U9174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.