NPIMap

Individual provider Active NPI

Koral Ben-Simon, APRN

  • Family Nurse Practitioner
  • South Windsor, CT
National Provider Identifier
1174080477
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8110 Issued in CT
Practice address
70 Buckland Rd
South Windsor, CT 06074-3702
Phone
(860) 648-0707
NPI assigned
Feb 23, 2019
Last updated
Jan 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8110 CT Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190319000400 CT Practitioner - Nurse Practitioner 9335489947 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

Practice addresses (Care Compare)

540 Saybrook Rd
Suite 210
Middletown, CT 06457-4759
Phone (860) 358-2470

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Jan 12, 2026 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Sep 1, 2019 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Apr 1, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Sep 1, 2019 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince May 1, 2022 Accepting new patients
Middlesex Hospital Family CurrentSince Jan 12, 2026 Accepting new patients
Middlesex Hospital Past Accepting new patients

Locations

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

540 Saybrook Rd
Ste 210
Middletown, CT 06457
Phone (860) 344-1801

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

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

  • Direct secure messaging: npkben-simon@endocrineofwm.medentdirect.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1550880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1174080477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 STEEP RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060741339",
            "telephone_number": "914-462-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BUCKLAND RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743702",
            "telephone_number": "860-648-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEN-SIMON",
        "first_name": "KORAL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-23",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Windsor, CT

Sources for this page

Verify at the official NPI Registry.