Individual provider Active NPI

Simona C Eng, DO

  • Internal Medicine Physician
  • Salisbury, MD
National Provider Identifier
1265431027
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H0057410 Issued in MD
Practice address
100 E Carroll St
Salisbury, MD 21801-5422
Phone
(410) 543-7536
Fax
(410) 543-7272
NPI assigned
Jul 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H0057410 MD Primary

Addresses

Primary practice location

100 E Carroll St
Salisbury, MD 21801-5422

Mailing address

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 543-7536

Other identifiers 2

IdentifierTypeStateIssuer
757000700MedicaidMD
1000032900MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20040706000051 MD Practitioner - Internal Medicine 8921085291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 912-4976

Merit-based Incentive Payment System (MIPS)

Final score
82.92 of 100Reported as group
Quality
74.47
Promoting interoperability
92
Improvement activities
40
Cost
75.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Peninsula Regional, Inc. Internal Medicine CurrentSince Aug 1, 2001 Accepting new patients
Tidalhealth Peninsula Regional, Inc. CurrentSince Aug 1, 2001 Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

106 Milford St
Ste 201
Salisbury, MD 21804
Phone (410) 543-1616

145 E Carroll St
Salisbury, MD 21801
Phone (410) 546-6400

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tidalhealth Peninsula Regional IncSalisbury, MD, CCN 210019 Hospital Corporate Director Oct 31, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1265431027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-543-7536",
            "fax_number": "410-543-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-543-7536",
            "fax_number": "410-543-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENG",
        "first_name": "SIMONA",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "H0057410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "757000700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000032900",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.