Individual provider Active NPI

Kathryn Karo Simon, MD

  • Dermatology Physician
  • Bryn Mawr, PA
National Provider Identifier
1376645374
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
039207E Issued in PA
Practice address
875 County Line Road
Suite 207 Bryn Mawr Medical BLDG South
Bryn Mawr, PA 19010-3113
Phone
(610) 525-1920
Fax
(610) 525-8393
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 039207E PA Primary

Addresses

Primary practice location

875 County Line Road
Suite 207 Bryn Mawr Medical BLDG South
Bryn Mawr, PA 19010-3113

Mailing address

875 County Line Road
Suite 207 Bryn Mawr Medical BLDG South
Bryn Mawr, PA 19010-3113
Phone (610) 525-1920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
039207EPAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Karen K Deasey MD Dermatology CurrentSince Oct 25, 2020 Accepting new patients
Pennsylvania Dermatology Partners Inc Dermatology PastSince Aug 1, 2023 Accepting new patients

Locations

875 County Line Rd
Ste 207
Bryn Mawr, PA 19010
Phone (215) 525-1920

945 E Haverford Rd
Ste 6
Bryn Mawr, PA 19010
Phone (610) 525-1920

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1376645374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 COUNTY LINE ROAD",
            "address_2": "SUITE 207 BRYN MAWR MEDICAL BLDG SOUTH",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103113",
            "telephone_number": "610-525-1920",
            "fax_number": "610-525-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 COUNTY LINE ROAD",
            "address_2": "SUITE 207 BRYN MAWR MEDICAL BLDG SOUTH",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103113",
            "telephone_number": "610-525-1920",
            "fax_number": "610-525-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "KATHRYN",
        "middle_name": "KARO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "039207E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.