Active NPI
Simona Bianconi, M.D.
- Pediatrics Physician
- Bethesda, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 241805
- Practice address
- 10 Center Dr
Building 10 Room 9D42
Bethesda, MD 20892-0001 - Phone
- (301) 496-8217
- NPI assigned
- Jun 3, 2010
- Sex
- Female
- Sole proprietor
- No
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 | 241805 | NY | Primary |
Addresses
Primary practice location
10 Center Dr
Building 10 Room 9D42
Bethesda, MD 20892-0001
Mailing address
10 Center Dr
Building 10 Room 9D42
Bethesda, MD 20892-0001
Phone (301) 496-8217
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Medical Genetics and Genomics
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
4405 Vandever Ave
San Diego, CA 92120-3315
Phone (619) 516-6606
4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 241805 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Sharp Rees-Stealy Medical Group, Inc | Current | Accepting new patients | |
| Sharp Rees-Stealy Medical Group, Inc | Pediatrics | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
4760 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-0567
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000
4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038
2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500
10243 Genetic Center Dr
San Diego, CA 92121
Phone (858) 499-2704
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- San Diego, CA
- NPI 1285616177
Pediatrics
-
- Health Maintenance Organization
- Riverside, CA
- NPI 1316979834
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Optometrist
- San Diego, CA
- NPI 1063172351
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Anaheim, CA
- NPI 1952333460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1235459140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CENTER DR",
"address_2": "BUILDING 10 ROOM 9D42",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208920001",
"telephone_number": "301-496-8217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CENTER DR",
"address_2": "BUILDING 10 ROOM 9D42",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208920001",
"telephone_number": "301-496-8217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIANCONI",
"first_name": "SIMONA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-03",
"last_updated": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "241805",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4760 W Sunset Blvd",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900276063",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.