Individual provider Active NPI

Todd Simon, DO

  • Gastroenterology Physician
  • Atlantis, FL
National Provider Identifier
1225073489
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
OS6993 Issued in FL
Practice address
5401 S Congress Ave Ste 211
Atlantis, FL 33462-6637
Phone
(561) 964-8221
Fax
(561) 964-7393
NPI assigned
Jun 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X OS6993 FL Primary

Addresses

Primary practice location

5401 S Congress Ave Ste 211
Atlantis, FL 33462-6637

Mailing address

5401 S Congress Ave Ste 211
Atlantis, FL 33462-6637
Phone (561) 964-8221

Other practice location 1

10115 Forest Hill Blvd Ste 200
Wellington, FL 33414-3104
Phone (561) 964-8221

Other practice location 2

500 University Blvd Ste 116
Jupiter, FL 33458-2774
Phone (561) 964-8221

Other identifiers 1

IdentifierTypeStateIssuer
268898100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100420000837 FL Practitioner - Gastroenterology 7810085818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5401 S Congress Ave
Suite 211
Atlantis, FL 33462-6637
Phone (214) 424-2200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy92
Upper gastrointestinal (GI) endoscopy for acid reflux64

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1225073489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 S CONGRESS AVE STE 211",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626637",
            "telephone_number": "561-964-8221",
            "fax_number": "561-964-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 S CONGRESS AVE STE 211",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626637",
            "telephone_number": "561-964-8221",
            "fax_number": "561-964-7393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10115 Forest Hill Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334143104",
            "country_code": "US",
            "telephone_number": "561-964-8221",
            "fax_number": "561-964-7393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 University Blvd Ste 116",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334582774",
            "country_code": "US",
            "telephone_number": "561-964-8221",
            "fax_number": "561-964-7393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "TODD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "OS6993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268898100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

Verify at the official NPI Registry.