Individual provider Active NPI

Nathan Simon, MD

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1164867966
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01077776A Issued in IN
Practice address
1402 E County Line Rd
Indianapolis, IN 46227-0963
Phone
(317) 887-7000
NPI assigned
May 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI
Anesthesiology Physician 207L00000X 01077776A IN Primary

Addresses

Primary practice location

1402 E County Line Rd
Indianapolis, IN 46227-0963

Mailing address

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4280

Other practice location 1

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20170614001839 IN Practitioner - Anesthesiology 2961719448 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iceland Anesthesia Management LLCGroup PAC ID 7618372996, 75 clinicians
Jebs Anesthesia Consultants, LLCGroup PAC ID 4486046646, 37 clinicians

Practice addresses (Care Compare)

1421 N 7TH St
Terre Haute, IN 47807-1005
Phone (812) 232-7192

3212 Hickory Rd
Suite a
Mishawaka, IN 46545-8863
Phone (574) 855-2223

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.34 of 100Reported as apm
Quality
88.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Sep 30, 2024 Accepting new patients
Bloomington Anesthesiologists PC Anesthesiology CurrentSince Jul 31, 2017 Accepting new patients
Jebs Anesthesia Consultants, LLC Anesthesiology CurrentSince Jun 10, 2023 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 30, 2024 Accepting new patients
Iceland Anesthesia Management, LLC Anesthesiology CurrentSince Nov 17, 2022 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

1020 High Rd
Bremen, IN 46506
Phone (574) 309-9967

801 S Main St
Clinton, IN 47842
Phone (765) 832-1212

4411 Washington Ave
Ste 100
Evansville, IN 47714
Phone (313) 637-9861

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

900 I St
Laporte, IN 46350
Phone (219) 324-1670

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

3212 Hickory Rd
Ste A
Mishawaka, IN 46545
Phone (574) 251-0498

1402 E County Line Rd
Southport, IN 46227
Phone (317) 887-7000

1421 N 7th St
Terre Haute, IN 47807
Phone (812) 231-4604

Interoperability endpoints

  • Direct secure messaging: nsimon626706@ecommunitydirect.com

Organizations & group practices 5

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 2

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": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1164867966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4280",
            "fax_number": "734-936-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 E COUNTY LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462270963",
            "telephone_number": "317-887-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095000",
            "country_code": "US",
            "telephone_number": "734-936-4280",
            "fax_number": "734-936-9091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "NATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01077776A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.