Individual provider Active NPI

James Paul Simeone, PTA BBA

  • Physical Therapy Assistant
  • Novi, MI
National Provider Identifier
1093770588
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502003165 Issued in MI
Practice address
23655 Novi Rd Ste 101
Novi, MI 48375-5442
Phone
(248) 277-3440
Fax
(248) 277-3441
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502003165 MI Primary

Addresses

Primary practice location

23655 Novi Rd Ste 101
Novi, MI 48375-5442

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258

Other practice location 1

23550 Park St
Ste 101
Dearborn, MI 48124
Phone (313) 724-0136

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5502003165MIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dearborn Physical Therapy LTD. Past Accepting new patients
Team Rehabilitation Services, LLC PastSince Feb 25, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1093770588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23655 NOVI RD STE 101",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483755442",
            "telephone_number": "248-277-3440",
            "fax_number": "248-277-3441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23550 Park St",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "48124",
            "country_code": "US",
            "telephone_number": "313-724-0136",
            "fax_number": "313-724-0136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMEONE",
        "first_name": "JAMES",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PTA  BBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502003165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.