Individual provider Active NPI

Simona I Hategan, DDS

  • General Practice Dentistry
  • Bronx, NY
National Provider Identifier
1376220913
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
065093 Issued in NY
Practice address
234 E 149TH St # 2A8
Bronx, NY 10451-5589
Phone
(718) 579-5690
NPI assigned
Jul 4, 2023
Last updated
Oct 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 065093 NY Primary

Addresses

Primary practice location

234 E 149TH St # 2A8
Bronx, NY 10451-5589

Mailing address

4751 43Rd St Apt 3R
Woodside, NY 11377-6220
Phone (718) 579-5690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251223002254 NY Practitioner - Dentist 0042705444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

234 E 149 St
Bronx, NY 10451-5504

2758 Middle Country Rd
Lake Grove, NY 11755-2118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
065093NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Oct 3, 2025 Accepting new patients
Lincoln Medical and Mental Heath Center PastSince Sep 28, 2025 Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Interoperability endpoints

  • Direct secure messaging: shategan3833889@nychhc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1376220913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4751 43RD ST APT 3R",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113776220",
            "telephone_number": "718-579-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST # 2A8",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515589",
            "telephone_number": "718-579-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATEGAN",
        "first_name": "SIMONA",
        "middle_name": "I",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-04",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "065093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.