Individual provider Active NPI

Ashley N Simone, PH.D

  • Clinical Neuropsychologist
  • Brookfield, CT
National Provider Identifier
1194248609
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
3850 Issued in CT
Practice address
246 Federal Rd Ste C23A
Brookfield, CT 06804-2640
Phone
(203) 364-4828
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 3850 CT Primary

Addresses

Primary practice location

246 Federal Rd Ste C23A
Brookfield, CT 06804-2640

Mailing address

246 Federal Rd Ste C23A
Brookfield, CT 06804-2640
Phone (203) 364-4828

Other practice location 1

50 Gaylord Farm Rd
Wallingford, CT 06492-2828
Phone (203) 284-2800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190830002264 CT Practitioner - Clinical Psychologist 8628307527 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gaylord Hospital, Inc. CurrentSince Sep 1, 2019 Accepting new patients
The Developing and Aging Brain, LLC CurrentSince Sep 30, 2021 Accepting new patients

Locations

246 Federal Rd
Ste C23A
Brookfield, CT 06804
Phone (203) 364-4828

50 Gaylord Farm Rd
Wallingford, CT 06492
Phone (203) 679-3553

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1194248609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 FEDERAL RD STE C23A",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042640",
            "telephone_number": "203-364-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 FEDERAL RD STE C23A",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042640",
            "telephone_number": "203-364-4828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Gaylord Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Wallingford",
            "state": "CT",
            "postal_code": "064922828",
            "country_code": "US",
            "telephone_number": "203-284-2800",
            "fax_number": "203-294-8734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONE",
        "first_name": "ASHLEY",
        "middle_name": "N",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "3850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

Verify at the official NPI Registry.