Individual provider Active NPI

Eric Todd Simolke, P.A.

  • Physician Assistant
  • Shreveport, LA
National Provider Identifier
1316960966
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.A10318 Issued in LA
Practice address
1453 E Bert Kouns Industrial Loop Ste 319
Shreveport, LA 71105-6800
Phone
(318) 681-1968
Fax
(318) 681-1969
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.A10318 LA Primary

Addresses

Primary practice location

1453 E Bert Kouns Industrial Loop Ste 319
Shreveport, LA 71105-6800

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 606-6400

Other practice location 1

1501 Kings Hwy
Department of Surgery
Shreveport, LA 71103-4228
Phone (318) 813-2655

Other identifiers 1

IdentifierTypeStateIssuer
1624918MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20041021000545 LA Practitioner - Physician Assistant 2860453008 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spine Institute of Louisiana LLCGroup PAC ID 3375719446, 13 clinicians

Practice addresses (Care Compare)

1500 Line Ave
Suite 200
Shreveport, LA 71101-4643
Phone (318) 629-5560

Hospital & facility affiliations

  • Specialists Hospital Shreveport Hospital, Shreveport, LA, CCN 190278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.A10318LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University Health Sciences Center Shreveport CurrentSince Oct 8, 2016 Accepting new patients
Louisiana State University Health Sciences Center CurrentSince Oct 8, 2016 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Mar 4, 2024 Accepting new patients
C H Wilkinson Physician Network CurrentSince Nov 13, 2017 Accepting new patients
C H Wilkinson Physician Network Physician Assistant CurrentSince Nov 13, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Mar 4, 2024 Accepting new patients

Locations

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1453 E Bert Kouns Industrial Loop
Ste 319
Shreveport, LA 71105
Phone (318) 681-1675

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

919 Hidden Rdg
Irving, TX 75038

Interoperability endpoints

  • Direct secure messaging: eric.simolke.p1@direct.sil.nextgenshare.com
  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: esimolke355166@christushealth.direct-ci.net

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1316960966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-606-6400",
            "fax_number": "903-606-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP STE 319",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711056800",
            "telephone_number": "318-681-1968",
            "fax_number": "318-681-1969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kings Hwy",
            "address_2": "Department of Surgery",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-813-2655",
            "fax_number": "318-813-2673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMOLKE",
        "first_name": "ERIC",
        "middle_name": "TODD",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.A10318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1624918",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.