Individual provider Active NPI

Simmi Fain, M. D.

  • Diagnostic Radiology Physician
  • Davenport, IA
National Provider Identifier
1386094860
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
R-10650 Issued in IA
Practice address
1970 E 53Rd St
Davenport, IA 52807-2710
Phone
(563) 359-3949
NPI assigned
Jun 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X R-10650 IA Primary

Addresses

Primary practice location

1970 E 53Rd St
Davenport, IA 52807-2710

Mailing address

1970 E 53Rd St
Davenport, IA 52807-2710
Phone (563) 359-3949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210719001457 IL Practitioner - Diagnostic Radiology 8123310406 Reassigns benefits to 1 organization
I20210723001201 IA Practitioner - Diagnostic Radiology 8123310406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, San Diego School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Group PC SCGroup PAC ID 9032008537, 39 clinicians

Practice addresses (Care Compare)

10 Brown Deer KNLS
Coralville, IA 52241-1173
Phone (563) 421-9729

1227 E Rusholme St
Davenport, IA 52803-2459
Phone (563) 421-9729

1401 W Central Park Ave
Davenport, IA 52804-1707
Phone (563) 421-9729

1410 N 4TH St
Clinton, IA 52732-2940
Phone (563) 244-5615

1970 E 53Rd St
Davenport, IA 52807-2710

3385 Dexter CT
Suite 300
Davenport, IA 52807-3471
Phone (563) 421-9729

4620 Willowwood CT
Davenport, IA 52807-3445
Phone (563) 344-5490

801 Illini Dr
Silvis, IL 61282-1804
Phone (309) 281-4000

Hospital & facility affiliations

  • Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033
  • Mercyone Clinton Medical Center Hospital, Clinton, IA, CCN 160080
  • Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275
  • Mercyone Genesis Dewitt Medical Center Hospital, Dewitt, IA, CCN 161313
  • Genesis Medical Center, Aledo Hospital, Aledo, IL, CCN 141304

Merit-based Incentive Payment System (MIPS)

Final score
92.11 of 100Reported as group
Quality
90.72
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-10650IAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sfain3932225@direct.trinity-health.org

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.

Hospital & facility affiliations 5

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": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1386094860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072710",
            "telephone_number": "563-359-3949",
            "fax_number": "563-355-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072710",
            "telephone_number": "563-359-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIN",
        "first_name": "SIMMI",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "R-10650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.