Individual provider Active NPI

Cameron Simonsen, D.O.

  • Internal Medicine Physician
  • Waco, TX
National Provider Identifier
1235517194
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R4326 Issued in TX
Practice address
100 Hillcrest Medical Blvd
Waco, TX 76712-8897
Phone
(254) 215-9481
NPI assigned
May 12, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10054292 TX
Internal Medicine Physician 207R00000X R4326 TX Primary

Addresses

Primary practice location

100 Hillcrest Medical Blvd
Waco, TX 76712-8897

Mailing address

PO Box 848491
Dallas, TX 75284-8491
Phone (254) 202-9330

Other practice location 1

2401 S 31st St
Temple, TX 76508-0001
Phone (254) 724-2364

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csimonsen72941@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20171019000727 TX Practitioner - Internal Medicine 1557642626 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillcrest Physician ServicesGroup PAC ID 1153304456, 114 clinicians

Practice addresses (Care Compare)

100 Hillcrest Med Blvde
Waco, TX 76712-8897
Phone (254) 202-2000

140 Hillcrest Medical Blvd
Waco, TX 76712-8897

150 Hillcrest Medical Blvd
Waco, TX 76712-8897
Phone (254) 202-4000

50 Hillcrest Medical Blvd
Waco, TX 76712-8955

50 Hillcrest Medical Blvd
Suite 206
Waco, TX 76712-8954
Phone (254) 202-7950

Hospital & facility affiliations

  • Magnolia Hospice Hospice, Waco, TX, CCN 671795
  • Baylor Scott & White Medical Center Hillcrest Hospital, Waco, TX, CCN 450101

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hillcrest Physician Services Internal Medicine CurrentSince Sep 7, 2018 Accepting new patients
Scott & White Clinic Internal Medicine CurrentSince Oct 6, 2017 Accepting new patients
Scott & White Clinic Internal Medicine CurrentSince Oct 6, 2017 Accepting new patients
Hillcrest Baptist Medical Center Past Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

100 Hillcrest Medical Blvd
Waco, TX 76712
Phone (254) 202-2000

50 Hillcrest Medical Blvd
Waco, TX 76712
Phone (254) 202-7300

Organizations & group practices 5

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 2

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": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1235517194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848491",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752848491",
            "telephone_number": "254-202-9330",
            "fax_number": "254-202-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HILLCREST MEDICAL BLVD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128897",
            "telephone_number": "254-215-9481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-2364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONSEN",
        "first_name": "CAMERON",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10054292",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R4326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csimonsen72941@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 Hillcrest Medical Blvd",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767128897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.