Active NPI
Mary F Simon, M.D.
- Pediatrics Physician
- Fresno, CA
National Provider Identifier
1194711275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 40323
- Practice address
- 5715 N West Ave Ste 102
Fresno, CA 93711-2376 - Phone
- (559) 228-3069
- Fax
- (559) 228-9228
- NPI assigned
- Sep 23, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 40323 | CA | Primary |
Addresses
Primary practice location
5715 N West Ave Ste 102
Fresno, CA 93711-2376
Mailing address
5715 N West Ave Ste 102
Fresno, CA 93711-2376
Phone (559) 228-3069
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A403230 | Other | CA | BLUE SHIELD PIN |
| 00A403231 | Medicaid | CA |
Other names 1
- Mary F Weisberg
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oak Haven Medical Group Inc | Past | Accepting new patients | |
| Central Star Behavioral Health, Inc. | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Fresno, CA
- NPI 1255218905
-
- Endocrinology, Diabetes & Metabolism Physician
- Visalia, CA
- NPI 1265001002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424390400000",
"number": "1194711275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5715 N WEST AVE STE 102",
"city": "FRESNO",
"state": "CA",
"postal_code": "937112376",
"telephone_number": "559-228-3069",
"fax_number": "559-228-9228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5715 N WEST AVE STE 102",
"city": "FRESNO",
"state": "CA",
"postal_code": "937112376",
"telephone_number": "559-228-3069",
"fax_number": "559-228-9228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "MARY",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-23",
"last_updated": "2015-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "40323",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PIN",
"identifier": "00A403230",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A403231",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "WEISBERG",
"middle_name": "F",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.