Individual provider Active NPI

Iulia Gabriela Simon, APRN

  • Student in an Organized Health Care Education/Training Program
  • Fresno, CA
National Provider Identifier
1265974059
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
20 River Park PL W
Fresno, CA 93720
Phone
(559) 256-4968
NPI assigned
Nov 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN9475244 FL
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

20 River Park PL W
Fresno, CA 93720

Mailing address

20 River Park PL W,
Fresno, CA 93720
Phone (559) 256-4968

Other identifiers 1

IdentifierTypeStateIssuer
1265974059MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161223000459 NV Practitioner - Nurse Practitioner 2668753088 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Medical Group Coats LTD Current Accepting new patients
Nevada Acute Medical Services-Scherr 1 PC CurrentSince Jun 18, 2019 Accepting new patients
Cano Health Nevada PLLC PastSince Feb 1, 2021 Accepting new patients
Intermountain Medical Holdings Nevada Inc Past Accepting new patients

Locations

1250 S Valley View Blvd
Las Vegas, NV 89102
Phone (702) 259-3570

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

Organizations & group practices 4

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": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1265974059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 RIVER PARK PL W,",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-256-4968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 RIVER PARK PL W",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-256-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "IULIA",
        "middle_name": "GABRIELA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-09",
        "last_updated": "2024-06-06",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9475244",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265974059",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.