Organization Active NPI

David a Simonson DPM PA

  • Prosthetic/Orthotic Supplier
  • Rockledge, FL
National Provider Identifier
1194902049
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
PO2762 Issued in FL
Legal business name
DAVID A SIMONSON DPM PA
Practice address
1950 Rockledge Blvd
Ste# 107
Rockledge, FL 32955-3763
Phone
(321) 638-2121
Fax
(321) 638-2126
NPI assigned
Jan 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Authorized official

Name
Mrs. Faina Simonson, RN
Title
Office Manager
Phone
(321) 638-2121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X PO2762 FL Primary

Addresses

Primary practice location

1950 Rockledge Blvd
Ste# 107
Rockledge, FL 32955-3763

Mailing address

1950 Rockledge Blvd
Ste# 107
Rockledge, FL 32955-3763
Phone (321) 638-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100115000076 FL Part B Supplier - Clinic/Group Practice 6800938739 Receives reassigned benefits from 3 practitioners
Practice locations: Rockledge, FL

National Provider Directory

National Provider Directory

Locations

1950 US Highway 1
Ste 107
Rockledge, FL 32955
Phone (321) 638-2121

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323907200000",
    "number": "1194902049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 ROCKLEDGE BLVD",
            "address_2": "STE# 107",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553763",
            "telephone_number": "321-638-2121",
            "fax_number": "321-638-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 ROCKLEDGE BLVD",
            "address_2": "STE# 107",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553763",
            "telephone_number": "321-638-2121",
            "fax_number": "321-638-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A SIMONSON DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2011-12-15",
        "status": "A",
        "authorized_official_last_name": "SIMONSON",
        "authorized_official_first_name": "FAINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "321-638-2121",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "PO2762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.