Individual provider Active NPI

Scott Simecek II, D.O.

  • Pulmonary Disease Physician
  • Clarkston, MI
National Provider Identifier
1104865765
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
5101011869 Issued in MI
Practice address
5701 Bow Pointe Dr
Ste 365
Clarkston, MI 48346-3198
Phone
(248) 922-9283
Fax
(248) 922-9286
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 5101011869 MI
Sleep Medicine (Internal Medicine) Physician 207RS0012X 5101011869 MI
Pulmonary Disease Physician 207RP1001X 5101011869 MI Primary

Addresses

Primary practice location

5701 Bow Pointe Dr
Ste 365
Clarkston, MI 48346-3198

Mailing address

5701 Bow Pointe Dr Ste 365
Clarkston, MI 48346-5403
Phone (248) 922-9283

Other identifiers 1

IdentifierTypeStateIssuer
4234474MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050922001054 MI Practitioner - Pulmonary Disease 9032143607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
R Franklin University of Med & Sci/Chicago Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary and Critical Care Medicine Consultants PCGroup PAC ID 3870527443, 3 clinicians

Practice addresses (Care Compare)

5701 Bow Pointe Dr
Suite 365
Clarkston, MI 48346-5403
Phone (248) 922-9283

Hospital & facility affiliations

  • Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277
  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
  • McLaren Oakland Hospital, Pontiac, MI, CCN 230207

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101011869MIMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJMH Medical Practice-SMHC Pulmonary Disease PastSince Oct 1, 2000 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ssimecek1151391@direct.hfhs.org
  • Direct secure messaging: ssimecek@direct.dmc.org

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 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1104865765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR STE 365",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483465403",
            "telephone_number": "248-922-9283",
            "fax_number": "248-922-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR",
            "address_2": "STE 365",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463198",
            "telephone_number": "248-922-9283",
            "fax_number": "248-922-9286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMECEK",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "5101011869",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MI",
            "license": "5101011869",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "5101011869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4234474",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.