Active NPI
John Carl Simkevich, DMD
- Oral and Maxillofacial Surgery (Dentist)
- East Greenwich, RI
National Provider Identifier
1093746539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 1655
- Practice address
- 990 Main St
East Greenwich, RI 02818-3187 - Phone
- (401) 885-8575
- Fax
- (401) 885-8577
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 1655 | RI | Primary |
Addresses
Primary practice location
990 Main St
East Greenwich, RI 02818-3187
Mailing address
990 Main St
East Greenwich, RI 02818-3187
Phone (401) 885-8575
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145484 | Other | RI | UNITED HEALTH SENIOR-PAWT |
| 5657159 | Other | RI | AETNA |
| 8447-5 | Other | RI | BLUE CROSS-COV |
| 3068099 | Other | RI | AETNA HMO EG |
| 3068101 | Other | RI | AETNA HMO- COV |
| 2001655 | Other | RI | DELTA DENTAL -PAWT |
| 5001655 | Other | RI | DELTA DENTAL-COV |
| 8000056 | Other | RI | UNITED HEALTH-EG |
| 8356-2 | Other | RI | BLUE CROSS-PAWT |
| 8442-0 | Other | RI | BLUE CROSS-EG |
| 145483 | Other | RI | UNITED SENIOR-EG |
| 8000057 | Other | RI | UNITED HEALTH-COV |
| 8000075 | Other | RI | UNITED HEALTH-PAWT |
| 3068102 | Other | RI | AETNA-HMO |
| 4001655 | Other | RI | DELTA DENTAL -EG |
| 145482 | Other | RI | UNITED SENIOR-COV |
| 201298 | Other | RI | BLUE CHIP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1655 | RI | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202169600000",
"number": "1093746539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 MAIN ST",
"city": "EAST GREENWICH",
"state": "RI",
"postal_code": "028183187",
"telephone_number": "401-885-8575",
"fax_number": "401-885-8577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 MAIN ST",
"city": "EAST GREENWICH",
"state": "RI",
"postal_code": "028183187",
"telephone_number": "401-885-8575",
"fax_number": "401-885-8577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMKEVICH",
"first_name": "JOHN",
"middle_name": "CARL",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2008-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "RI",
"license": "1655",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH SENIOR-PAWT",
"identifier": "145484",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5657159",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-COV",
"identifier": "8447-5",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO EG",
"identifier": "3068099",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO- COV",
"identifier": "3068101",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL -PAWT",
"identifier": "2001655",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL-COV",
"identifier": "5001655",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH-EG",
"identifier": "8000056",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-PAWT",
"identifier": "8356-2",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-EG",
"identifier": "8442-0",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED SENIOR-EG",
"identifier": "145483",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH-COV",
"identifier": "8000057",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH-PAWT",
"identifier": "8000075",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA-HMO",
"identifier": "3068102",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL -EG",
"identifier": "4001655",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED SENIOR-COV",
"identifier": "145482",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "201298",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Greenwich, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.