NPIMap

Individual provider Active NPI

John Ernest Simon, M.D.

  • Psychiatry Physician
  • Minneapolis, MN
National Provider Identifier
1255374609
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
23781 Issued in 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
Last updated
Oct 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 23781 MN Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060725000378 MN Practitioner - Psychiatry 7911972534 Reassigns benefits to 5 organizations
I20070831000272 WI Practitioner - Psychiatry 7911972534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 CountyGroup PAC ID 3779676044, 9 clinicians
Vinland National CenterGroup PAC ID 1557516184, 7 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Vinland National Center CurrentSince Nov 3, 2012 Accepting new patients
Creative Psychopharmacology Inc Psychiatry CurrentSince Aug 5, 2007 Accepting new patients
St Croix County CurrentSince Aug 8, 2006 Accepting new patients
Range Regional Health Services CurrentSince Aug 18, 2020 Accepting new patients
Range Regional Health Services CurrentSince Aug 18, 2020 Accepting new patients
Fairview Express Care CurrentSince Jun 17, 2022 Accepting new patients
Fairview Specialty Services CurrentSince Jun 17, 2022 Accepting new patients
St Croix County Current Accepting new patients
Fairview Health Services CurrentSince Jun 17, 2022 Accepting new patients
Karol, PC Past Accepting new patients
Clinical Psychopharmacology Consultants, PA Past Accepting new patients
Fairview Health Services Past Accepting new patients
Volunteers of America of MN 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

1300 Godward St NE
Ste 6900
Minneapolis, MN 55413
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

701 25th Ave S
#303
Minneapolis, MN 55454
Phone (612) 333-9954

701 25th Ave S
Ste 303
Minneapolis, MN 55454
Phone (612) 333-9954

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

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

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 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1255374609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 25TH AVE S",
            "address_2": "#303",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541513",
            "telephone_number": "612-333-9954",
            "fax_number": "612-333-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 25TH AVE S",
            "address_2": "#303",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541513",
            "telephone_number": "612-333-9954",
            "fax_number": "612-333-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JOHN",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "23781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.