John Ernest Simon, M.D.
Individual provider Active NPI Psychiatry Physician · Minneapolis, MN
NPI 1255374609 · NPPES record last updated Oct 19, 2007
Key facts
- NPI
- 1255374609
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 23781 (MN)
- Practice address
- 701 25TH Ave S
#303
Minneapolis, MN 55454-1513 - Phone
- (612) 333-9954
- Fax
- (612) 333-9969
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 17
Hospital & facility affiliations 26
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- University of Nebraska College of Medicine, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- St Croix County
Vinland National Center
Practice addresses (Care Compare)
1300 Godward St NE
Minneapolis, MN 55413-3002
Phone (612) 333-9954
1752 Dorset LN
New Richmond, WI 54017-2452
Phone (715) 246-8330
3675 Ihduhapi Rd
Loretto, MN 55357-2120
Phone (763) 479-3555
Hospital & facility affiliations
- Abbott Northwestern Hospital
- M Health Fairview University of MN Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.44 of 100
- Quality
- 82.65
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.21
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060725000378 | MN | Practitioner - Psychiatry | 7911972534 | Reassigns benefits to 5 organizations |
| I20070831000272 | WI | Practitioner - Psychiatry | 7911972534 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23781 | MN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Specialty Services | Current |
Accepting new patients | |
| Range Regional Health Services | Current |
Accepting new patients | |
| St Croix County | Current |
Accepting new patients | |
| Creative Psychopharmacology Inc | Psychiatry | Current |
Accepting new patients |
| Fairview Express Care | Current | Accepting new patients | |
| Vinland National Center | Current |
Accepting new patients | |
| Fairview Health Services | Current |
Accepting new patients | |
| St Croix County | Current | Accepting new patients | |
| Fairview Express Care | Current |
Accepting new patients | |
| Range Regional Health Services | Current |
Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Health Services | Past | Accepting new patients | |
| Clinical Psychopharmacology Consultants, PA | Past | Accepting new patients | |
| Volunteers of America of MN | Past | Accepting new patients | |
| Karol, PC | Past | Accepting new patients |
Locations
201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000
750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441
3675 Ihduhapi Rd
Loretto, MN 55357
Phone (763) 479-3555
701 25th Ave S
Ste 303
Minneapolis, MN 55454
Phone (612) 333-9954
2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838
6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477
1300 Godward St NE
Ste 6900
Minneapolis, MN 55413
Phone (612) 333-9954
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
701 25th Ave S
#303
Minneapolis, MN 55454
Phone (612) 333-9954
402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
1445 N 4th St
New Richmond, WI 54017
Phone (715) 246-6991
1752 Dorset Ln
New Richmond, WI 54017
Phone (715) 246-6991
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 23781 | MN | Yes |
Addresses
Primary practice location
701 25TH Ave S
#303
Minneapolis, MN 55454-1513
Mailing address
701 25TH Ave S
#303
Minneapolis, MN 55454-1513
Phone (612) 333-9954
Other providers in Minneapolis, MN
- Keri Megan Simmons
- Lisa Noelle Simmons
- Rachele Denise Simmons
- Samuel Simmons Jr.
- Annika Simon
- Kaja Simon
- Kelly Marie Simon
- Kristie Simon
- Nitin Simon
- Curtis James Simondet
All providers in Minneapolis, MN · Psychiatry Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.