NPIMap

Individual provider Active NPI

Colette Simon, M.D.

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Wyomissing, PA
National Provider Identifier
1235245036
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
License
MD452766 Issued in PA
Practice address
2603 Keiser Blvd Ste 204
Wyomissing, PA 19610-3356
Phone
(484) 628-3939
Fax
(484) 628-3940
NPI assigned
Aug 22, 2006
Last updated
Oct 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD452766 PA
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X MD452766 PA Primary

Addresses

Primary practice location

2603 Keiser Blvd Ste 204
Wyomissing, PA 19610-3356

Mailing address

2603 Keiser Blvd Ste 204
Wyomissing, PA 19610-3356
Phone (484) 628-3939

Other identifiers 1

IdentifierTypeStateIssuer
072790OtherPAMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141002001558 PA Practitioner - Undersea and Hyperbaric MedicinePractitioner - Internal MedicinePractitioner - Preventive Medicine 7416919113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Undersea and Hyperbaric MedicineAlso: Internal Medicine, Preventive Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tower Health Medical GroupGroup PAC ID 7618889213, 578 clinicians

Practice addresses (Care Compare)

2603 Keiser Blvd
Suite 204
Wyomissing, PA 19610-3356
Phone (484) 628-3939

2610 Keiser Blvd
Wyomissing, PA 19610-3333
Phone (484) 750-3950

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.71 of 100Reported as group
Quality
73.34
Promoting interoperability
97
Improvement activities
40
Cost
78.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue35
Removal of skin lesions34
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD452766PAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group Current Accepting new patients
Reading Professional Services CurrentSince Aug 4, 2014 Accepting new patients
Tower Health Medical Group CurrentSince Aug 4, 2014 Accepting new patients
Tower Health Medical Group Undersea and Hyperbaric Medicine Past Accepting new patients
Tower Health Medical Group Past Accepting new patients
Correct Care, Inc. Past Accepting new patients
Tower Health Medical Group Past Accepting new patients
Tower Health Medical Group Past Accepting new patients
Tower Health Medical Group Past Accepting new patients
Coastal Bend Academic Physcians PA Past Accepting new patients
Tower Health Medical Group Past Accepting new patients
Tower Health Medical Group Past Accepting new patients
Tower Health Medical Group Past Accepting new patients
Tower Health Medical Group Past Accepting new patients
Tower Health Medical Group Past Accepting new patients
Tower Health Medical Group Past Accepting new patients

Locations

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

2603 Keiser Blvd
Ste 204
Wyomissing, PA 19610
Phone (484) 628-3939

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

Hospital & facility affiliations 8

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1235245036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 KEISER BLVD STE 204",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103356",
            "telephone_number": "484-628-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 KEISER BLVD STE 204",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103356",
            "telephone_number": "484-628-3939",
            "fax_number": "484-628-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "COLETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MD452766",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "PA",
            "license": "MD452766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "072790",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.