Individual provider Active NPI

Mitchell Steven Simon, D.C.

  • Chiropractor
  • Yonkers, NY
National Provider Identifier
1275682155
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
013165 Issued in NY
Practice address
45 Main St Apt 605
Yonkers, NY 10701-2964
Phone
(816) 810-9722
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33091 CA
Chiropractor 111N00000X 013165 NY Primary

Addresses

Primary practice location

45 Main St Apt 605
Yonkers, NY 10701-2964

Mailing address

45 Main St Apt 605
Yonkers, NY 10701-2964
Phone (816) 810-9722

Other practice location 1

57 W. 57th St
4th Floor
New York, NY 10019
Phone (816) 810-9722

Other identifiers 1

IdentifierTypeStateIssuer
34764017OtherMOBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33091CAMDMarriage & Family Therapist
013165NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Approach Chiropractic, LLC Chiropractor Past Accepting new patients
R.G. Medical, PC Past Accepting new patients

Organizations & group practices 2

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1275682155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MAIN ST APT 605",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107012964",
            "telephone_number": "816-810-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MAIN ST APT 605",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107012964",
            "telephone_number": "816-810-9722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 W. 57th St",
            "address_2": "4th Floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10019",
            "country_code": "US",
            "telephone_number": "816-810-9722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "MITCHELL",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33091",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "34764017",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.