Individual provider Active NPI

Simisola Kuye Williams, MD

  • Pediatrics Physician
  • Ft Worth, TX
National Provider Identifier
1245763887
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
T0546 Issued in TX
Practice address
3308 Deen Rd
Ft Worth, TX 76106-6524
Phone
(817) 702-1100
Fax
(817) 702-7097
NPI assigned
Apr 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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 T0546 TX
Pediatrics Physician 208000000X T0546 TX Primary

Addresses

Primary practice location

3308 Deen Rd
Ft Worth, TX 76106-6524

Mailing address

200 W Magnolia Ave Ste 201
Ft Worth, TX 76104-7657
Phone (817) 702-2977

Other names 1

  • Dr. Simisola Kuye Former name

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
I20230901002454 TX Practitioner - Pediatric MedicinePractitioner - Internal Medicine 4789961467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
University of Missouri, Kansas City, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Practice addresses (Care Compare)

3308 Deen Rd
Fort Worth, TX 76106-6524
Phone (817) 702-7000

Hospital & facility affiliations

  • JPS Health Network Hospital, Fort Worth, TX, CCN 450039

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
78.69

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Physician Group, Inc Internal Medicine CurrentSince Aug 7, 2023 Accepting new patients
University of Alabama Health Services Foundation, PC. Past Accepting new patients
Little Spurs Pediatric Urgent Care, PLLC Pediatrics PastSince May 1, 2021 Accepting new patients

Locations

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1500 S Main St
Fl 3
Ft Worth, TX 76104
Phone (817) 702-4360

200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450

3308 Deen Rd
Ft Worth, TX 76106
Phone (817) 702-1819

Interoperability endpoints

  • Direct secure messaging: swilliams102231@direct.jpshealth.org

Organizations & group practices 3

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 1

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": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1245763887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MAGNOLIA AVE STE 201",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761047657",
            "telephone_number": "817-702-2977",
            "fax_number": "817-702-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 DEEN RD",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761066524",
            "telephone_number": "817-702-1100",
            "fax_number": "817-702-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SIMISOLA",
        "middle_name": "KUYE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T0546",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T0546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIMISOLA",
            "last_name": "KUYE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ft Worth, TX

Sources for this page

Verify at the official NPI Registry.