Jeremy R Simon, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

036096781 Issued in IL

Practice address

7435 W Talcott Ave
Chicago, IL 60631-3707

Phone

(773) 792-5138

Fax

(773) 792-5124

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL, AZ, OH, TX, WA, TN, KY, CA, MI, WI, CT, NY, NJ13 enrollments

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 13

Specialty

Interventional RadiologyAlso: Diagnostic Radiology

Education

Other, 1995

Medicare assignment

May accept Medicare assignment

Group practices

Imaging Associates of Michigan PLLCGroup PAC ID 9537434386, 148 clinicians

Good Samaritan Regional Health CenterGroup PAC ID 1658272059, 155 clinicians

Imaging Associates of Indiana PCGroup PAC ID 1254503345, 293 clinicians

Premier Radiology Wisconsin LLCGroup PAC ID 9537595533, 111 clinicians

Radiology Affiliates of Central New Jersey PCGroup PAC ID 1759277239, 129 clinicians

Empire State Radiology P CGroup PAC ID 4385075241, 266 clinicians

Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

St Marys Hospital Centralia IllinoisGroup PAC ID 6709788920, 118 clinicians

Specialists in Medical Imaging SCGroup PAC ID 2163733544, 228 clinicians

Medical X-Ray Consultants LTDGroup PAC ID 3274447313, 38 clinicians

Northside Radiology Associates LLCGroup PAC ID 4486555398, 381 clinicians

Imaging Associates of New Mexico LLCGroup PAC ID 4981970233, 164 clinicians

Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Radiology Alliance PCGroup PAC ID 1850280470, 449 clinicians

County of ClayGroup PAC ID 0042101982, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046
• Deaconess Medical Center Hospital, Spokane, WA, CCN 500044
• Multicare Valley Hospital Hospital, Spokane Valley, WA, CCN 500119
• Capital Medical Center Hospital, Olympia, WA, CCN 500139
• Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 132)

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ei-jefferson

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.

• County of Clay

  • Critical Access Hospital
  • Flora, IL
  • NPI 1184655136

  IL

  Medicare reassignment Care Compare group NPD
• Good Samaritan Regional Health Center

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1487758801

  Diagnostic Radiology, IL

  Medicare reassignment Care Compare group NPD
• Specialists in Medical Imaging, SC

  • Diagnostic Radiology Physician
  • Olympia Fields, IL
  • NPI 1841687951

  Body Imaging, IL

  Medicare reassignment Care Compare group NPD
• St. Mary'S Hospital, Centralia, Illinois

  • Emergency Medicine Physician
  • Centralia, IL
  • NPI 1770687196

  Diagnostic Radiology, IL

  Medicare reassignment Care Compare group NPD
• Empire State Radiology P C

  • Diagnostic Radiology Physician
  • West Islip, NY
  • NPI 1255962783

  Diagnostic Radiology, IL, NY

  Medicare reassignment Care Compare group NPD
• Imaging Associates of Michigan PLLC

  • Diagnostic Radiology Physician
  • Marquette, MI
  • NPI 1164943007

  Diagnostic Radiology, IL, MI

  Medicare reassignment Care Compare group NPD
• Imaging Associates of New Mexico LLC

  • Diagnostic Radiology Physician
  • Albuquerque, NM
  • NPI 1629592464

  Diagnostic Radiology, IL

  Medicare reassignment Care Compare group NPD
• Medical X-Ray Consultants, LTD

  • Vascular & Interventional Radiology Physician
  • Alexandria, MN
  • NPI 1386601383

  Body Imaging, IL

  Medicare reassignment Care Compare group NPD
• Mori Bean and Brooks Inc

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1093782070

  Body Imaging, IL

  Medicare reassignment Care Compare group NPD
• Northside Radiology Associates LLC

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1013960657

  IL, Neuroradiology

  Medicare reassignment Care Compare group NPD
• Premier Radiology Wisconsin, LLC

  • Diagnostic Radiology Physician
  • Mount Pleasant, WI
  • NPI 1952951154

  Diagnostic Radiology, WI

  Medicare reassignment Care Compare group NPD
• Radiology Affiliates of Central New Jersey PC

  • Diagnostic Radiology Physician
  • Hamilton, NJ
  • NPI 1811994791

  IL, Neuroradiology, NJ

  Medicare reassignment Care Compare group NPD

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

• Good Samaritan Regional Health Center

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1609897339

  Hospital

  Care Compare affiliation
• Garnet Health Medical Center

  • General Acute Care Hospital
  • Middletown, NY
  • NPI 1609875772

  Hospital

  Care Compare affiliation
• Multicare Health System

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1356528269

  Hospital

  Care Compare affiliation
• Multicare Health System

  • General Acute Care Hospital
  • Spokane Valley, WA
  • NPI 1538345251

  Hospital

  Care Compare affiliation
• Multicare Health System

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1841258639

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1306865639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650068",
            "telephone_number": "847-412-9213",
            "fax_number": "847-412-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707",
            "telephone_number": "773-792-5138",
            "fax_number": "773-792-5124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JEREMY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "IL",
            "license": "036096781",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": "036096781",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "IL",
            "license": "036096781",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "IL",
            "license": "036096781",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036096781",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036096781",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "IL",
            "license": "0360969781",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096781-1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD-IL",
            "identifier": "0001619902",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad Zachary Simon
• David M Simon, M.D.
• Deja Simon
• Georgina Simon
• Honora Simon, PH.D, RD
• Joseph Pallikunnel Simon, PHARMD
• Julia Simon, M.D.
• Lauren Simon, DPM
• Mark Simon, M.D.
• Mary Kathleen Simon, PA-C

• All providers in Chicago, IL
• Vascular & Interventional Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.