NPIMap

Individual provider Active NPI

John J Simmer, M.D.

  • Otolaryngology Physician
  • Lakewood, WA
National Provider Identifier
1174594881
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
60167500 Issued in WA
Practice address
7424 Bridgeport Way West.
Suite 305
Lakewood, WA 98499-3402
Phone
(253) 301-6960
Fax
(253) 582-5938
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 34081 MN
Otolaryngology Physician 207Y00000X 60167500 WA Primary

Addresses

Primary practice location

7424 Bridgeport Way West.
Suite 305
Lakewood, WA 98499-3402

Mailing address

7424 Bridgeport Way West.
Suite 305
Lakewood, WA 98499-3402
Phone (253) 301-6960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101020000860 WA Practitioner - Otolaryngology 9537352737 Reassigns benefits to 1 organization
I20210427000262 MN Practitioner - Otolaryngology 9537352737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Minnesota Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34081MNMDInternal Medicine Physician
60167500WAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth Current Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Multicare Health System CurrentSince Sep 13, 2010 Accepting new patients
The Duluth Clinic LTD CurrentSince Jun 7, 2021 Accepting new patients
Multicare Health System Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jun 7, 2021 Accepting new patients
Multicare Health System CurrentSince Sep 13, 2010 Accepting new patients

Locations

502 E 2nd St
Duluth, MN 55805
Phone (218) 727-8762

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: john.simmer.simjohn@slk.direct.slhduluth.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 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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1174594881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7424 BRIDGEPORT WAY WEST.",
            "address_2": "SUITE 305",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993402",
            "telephone_number": "253-301-6960",
            "fax_number": "253-582-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7424 BRIDGEPORT WAY WEST.",
            "address_2": "SUITE 305",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993402",
            "telephone_number": "253-301-6960",
            "fax_number": "253-582-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMER",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "34081",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "60167500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.