NPIMap

Individual provider Active NPI

Derek Brent Simons, M.D.

  • Cardiovascular Disease Physician
  • Minneapolis, MN
National Provider Identifier
1285672949
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
279967 Issued in MN
Practice address
4040 Coon Rapids Blvd NW
Suite 120
Minneapolis, MN 55433-2522
Phone
(763) 427-9980
Fax
(763) 427-9908
NPI assigned
Jun 3, 2006
Last updated
Nov 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 279967 MN Primary

Addresses

Primary practice location

4040 Coon Rapids Blvd NW
Suite 120
Minneapolis, MN 55433-2522

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other identifiers 1

IdentifierTypeStateIssuer
180525800MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dsimons90481@excellian.direct.allina.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040802001340 MN Practitioner - Cardiovascular Disease (Cardiology) 9537050224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

4040 Coon Rapids Blvd NW
Suite 120
Coon Rapids, MN 55433-4568
Phone (763) 427-9980

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
279967MNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Allina Health System Past Accepting new patients
Metropolitan Cardiology Consultants Cardiovascular Disease Past Accepting new patients

Locations

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

4040 Coon Rapids Blvd NW
Ste 120
Minneapolis, MN 55433
Phone (763) 427-9980

6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980

Interoperability endpoints

  • Direct secure messaging: dsimons90481@excellian.direct.allina.com

Organizations & group practices 5

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.

Hospital & facility affiliations 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1285672949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 COON RAPIDS BLVD NW",
            "address_2": "SUITE 120",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554332522",
            "telephone_number": "763-427-9980",
            "fax_number": "763-427-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "DEREK",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "279967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180525800",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsimons90481@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "4040 Coon Rapids Blvd NW",
            "address_2": "Suite 120",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554332522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.