Individual provider Active NPI

Kenneth Simons, MD

  • Ophthalmology Physician
  • Milwaukee, WI
National Provider Identifier
1225089709
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
30163 Issued in WI
Practice address
925 N 87TH St
The Eye Institute
Milwaukee, WI 53226-4812
Phone
(414) 955-2020
Fax
(414) 955-6332
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 30163 WI Primary
Anatomic Pathology Physician 207ZP0101X 30163 WI

Addresses

Primary practice location

925 N 87TH St
The Eye Institute
Milwaukee, WI 53226-4812

Mailing address

925 N 87TH St
The Eye Institute
Milwaukee, WI 53226-4812
Phone (414) 955-2020

Other identifiers 2

IdentifierTypeStateIssuer
002000133OtherHUMANA
1225089709MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Jul 1, 1989 Accepting new patients

Locations

925 N 87th St
Milwaukee, WI 53226
Phone (414) 955-2020

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1225089709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 N 87TH ST",
            "address_2": "THE EYE INSTITUTE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264812",
            "telephone_number": "414-955-2020",
            "fax_number": "414-955-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 N 87TH ST",
            "address_2": "THE EYE INSTITUTE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264812",
            "telephone_number": "414-955-2020",
            "fax_number": "414-955-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "30163",
            "primary": true
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "WI",
            "license": "30163",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "002000133",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225089709",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.