Koral Ben-Simon, APRN
Individual provider Active NPI Family Nurse Practitioner · South Windsor, CT
NPI 1174080477 · NPPES record last updated Jan 10, 2022
Key facts
- NPI
- 1174080477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 8110 (CT)
- Practice address
- 70 Buckland Rd
South Windsor, CT 06074-3702 - Phone
- (860) 648-0707
- NPI assigned
- Feb 23, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Middlesex Hospital
Practice addresses (Care Compare)
540 Saybrook Rd
Suite 210
Middletown, CT 06457-4759
Phone (860) 358-2470
Hospital & facility affiliations
- Middlesex Hospital
- Baystate Medical Center
- Baystate Noble Hospital
- Mercy Medical Ctr
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190319000400 | CT | Practitioner - Nurse Practitioner | 9335489947 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8110 | CT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group Specialists, PLLC | Current |
Accepting new patients | |
| Hartford Healthcare Medical Group, Inc | Current |
Accepting new patients | |
| Middlesex Hospital | Family | Current |
Accepting new patients |
| Hartford Healthcare Medical Group Specialists LLC | Current |
Accepting new patients | |
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients | |
| Middlesex Hospital | Current |
Accepting new patients | |
| Middlesex Hospital | Past | Accepting new patients |
Locations
80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878
540 Saybrook Rd
Ste 210
Middletown, CT 06457
Phone (860) 344-1801
28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000
175 Capital Blvd
Fl 4
Rocky Hill, CT 06067
Phone (860) 380-0452
1559 Sullivan Ave
South Windsor, CT 06074
Phone (860) 696-2350
55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Interoperability endpoints
- npkben-simon@endocrineofwm.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 8110 | CT | Yes |
Addresses
Primary practice location
70 Buckland Rd
South Windsor, CT 06074-3702
Mailing address
49 Steep Rd
South Windsor, CT 06074-1339
Phone (914) 462-8444
Other providers in South Windsor, CT
- Katherine Beauregard
- Madelyn Rae Bedard
- Melissa Begley
- Jennifer Bellody
- Julianne Belsky
- Benchmark Assisted Living LLC
- Peter Benet
- Geneva Nicole Beresford
- Frederic Jacob Bernstein
- Between Now and Then
All providers in South Windsor, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.