Individual provider Active NPI

Robert Vincent Simeone, D.C.

  • Chiropractor
  • Staten Island, NY
National Provider Identifier
1104040138
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X0021441 Issued in NY
Practice address
456 Arlene St
Staten Island, NY 10314-3814
Phone
(718) 494-0675
Fax
(718) 370-0729
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X0021441 NY Primary

Addresses

Primary practice location

456 Arlene St
Staten Island, NY 10314-3814

Mailing address

456 Arlene St
Staten Island, NY 10314-3814
Phone (718) 494-0675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111206000020 NY Practitioner - Chiropractic 7618142571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

456 Arlene St
Staten Island, NY 10314-3814
Phone (718) 494-0675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002144NYMDCounselor
X0021441NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Robert V Simeone DC PC Chiropractor CurrentSince Jan 14, 1979 Accepting new patients

Locations

456 Arlene St
Staten Island, NY 10314
Phone (718) 477-9797

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.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104040138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 ARLENE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143814",
            "telephone_number": "718-494-0675",
            "fax_number": "718-370-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 ARLENE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143814",
            "telephone_number": "718-494-0675",
            "fax_number": "718-370-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMEONE",
        "first_name": "ROBERT",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0021441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.