Dustin T Simcoe

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10001987A Issued in IN

Practice address

401 Newporte Blvd
La Porte, IN 46350-4099

Phone

(219) 575-6244

Fax

(219) 380-0757

NPI assigned

Nov 3, 2015

Last updated

Jun 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Porte Clinic Company LLCGroup PAC ID 0446558357, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Health-la Porte Hospital, La Porte, IN, CCN 150006

Merit-based Incentive Payment System (MIPS)

Final score

90.68 of 100Reported as apm

Quality

76.2

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dustin.simcoe@laportehosp.cernerdirect.com

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.

• La Porte Clinic Company LLC

  • Internal Medicine Physician
  • Valparaiso, IN
  • NPI 1568829224
  Medicare reassignment Care Compare group
• La Porte Clinic Company LLC

  dba La Porte Physician Network Ophthalmology Care

  • Durable Medical Equipment & Medical Supplies
  • La Porte, IN
  • NPI 1275081788
  NPD
• Northwest Indiana Nephrology PC

  • Nephrology Physician
  • Valparaiso, IN
  • NPI 1285991885

  Multi-Specialty

  NPD (past)

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

• La Porte Hospital Company LLC

  dba Northwest Health-La Porte

  • General Acute Care Hospital
  • La Porte, IN
  • NPI 1750746285
  Care Compare affiliation

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1295108942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 KELLE DR",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463048708",
            "telephone_number": "219-364-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NEWPORTE BLVD",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463504099",
            "telephone_number": "219-575-6244",
            "fax_number": "219-380-0757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 Mapleview Rd",
            "address_purpose": "LOCATION",
            "city": "Wallingford",
            "state": "CT",
            "postal_code": "06492",
            "country_code": "US",
            "telephone_number": "765-620-2764",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "809 LaPorte Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463835801",
            "country_code": "US",
            "telephone_number": "219-263-4977",
            "fax_number": "219-263-4979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 Dickinson Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterton",
            "state": "IN",
            "postal_code": "463043387",
            "country_code": "US",
            "telephone_number": "219-926-7755",
            "fax_number": "219-929-1885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3630 Willowcreek Rd",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "IN",
            "postal_code": "463685075",
            "country_code": "US",
            "telephone_number": "219-364-3900",
            "fax_number": "219-364-3959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMCOE",
        "first_name": "DUSTIN",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001987A",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Dustin.Simcoe@laportehosp.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "401 NewPorte Blvd",
            "city": "La Porte",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463504099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sonali Shukla, MD
• Paul Shyposki, PT
• Vruti Pravin Sicinski, DDS
• Silver LLC (GENERx Pharmacy LLC)
• John Glenn Silver, LSW
• Amy Singh, PHARMD
• Linda S Sirugo, M.D.
• Jessica Sizemore, RBT
• SK Med LLC (Interventional Pain Specialists of Indiana)
• Amanda Smith, MS CCC SLP

• Physician Assistant in La Porte, IN
• Providers in La Porte, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.