Active NPI
Michael J Simons
- Orthopedic Physical Therapist
- Madison, WI
National Provider Identifier
1174690408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 3038-024
- Practice address
- 1 S Park St
Madison, WI 53715-1375 - Phone
- (608) 287-2350
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 3038-024 | WI | Primary |
Addresses
Primary practice location
1 S Park St
Madison, WI 53715-1375
Mailing address
1 S Park St
Madison, WI 53715-1375
Phone (608) 287-2350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36113500 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3038-024 | WI | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174690408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151375",
"telephone_number": "608-287-2350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151375",
"telephone_number": "608-287-2350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONS",
"first_name": "MICHAEL",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "WI",
"license": "3038-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36113500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.