Individual provider Active NPI

Albert Terry Simeone Jr., PA

  • Surgical Physician Assistant
  • Raleigh, NC
National Provider Identifier
1174928469
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
001005237 Issued in NC
Practice address
3000 New Bern Ave Ste 1100
Raleigh, NC 27610-1231
Phone
(919) 231-6333
Fax
(919) 231-6334
NPI assigned
Oct 29, 2014
Last updated
Feb 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001005237 NC
Surgical Physician Assistant 363AS0400X 001005237 NC Primary

Addresses

Primary practice location

3000 New Bern Ave Ste 1100
Raleigh, NC 27610-1231

Mailing address

PO Box 63362
Charlotte, NC 28263-3362
Phone (800) 782-6945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141215001349 NC Practitioner - Physician Assistant 9234451618 Reassigns benefits to 2 organizations
I20230116000617 CT Practitioner - Physician Assistant 9234451618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

2800 Main St
Bridgeport, CT 06606-4201

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001005237NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Surgical CurrentSince Feb 1, 2023 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Aug 22, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Feb 1, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jun 8, 2020 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jun 8, 2020 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Aug 22, 2019 Accepting new patients
Carolina Cardiovascular Surgical Associates P.a. Past Accepting new patients

Locations

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

3000 New Bern Ave
Ste 1100
Raleigh, NC 27610
Phone (919) 231-6333

Organizations & group practices 9

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 1

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": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1174928469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63362",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282633362",
            "telephone_number": "800-782-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE STE 1100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-231-6333",
            "fax_number": "919-231-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMEONE",
        "first_name": "ALBERT",
        "middle_name": "TERRY",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-29",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001005237",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "001005237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.