NPIMap

Individual provider Active NPI

Robert B Simonson, DO

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1407866056
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G0121 Issued in TX
Practice address
1441 N Beckley Ave
MMC Dallas
Dallas, TX 75203
Phone
(214) 942-5733
Fax
(214) 942-6115
NPI assigned
Aug 8, 2006
Last updated
Jan 9, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G0121 TX Primary

Addresses

Primary practice location

1441 N Beckley Ave
MMC Dallas
Dallas, TX 75203

Mailing address

4040 N Central Expy
#600
Dallas, TX 75204-3147
Phone (214) 520-5743

Other identifiers 2

IdentifierTypeStateIssuer
82951FOtherTXBLUE CROSS-BLUE SHIELD
133941802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100224000819 TX Practitioner - Emergency Medicine 6709876246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Physician Resources, LLPGroup PAC ID 7012161375, 91 clinicians

Practice addresses (Care Compare)

2700 E Broad St
Mansfield, TX 76063-5899
Phone (682) 622-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G0121TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Emergency Medicine CurrentSince Dec 21, 2009 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 21, 2009 Accepting new patients
Texas Physician Resources, LLP Emergency Medicine CurrentSince Feb 1, 2013 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 5

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.

Hospital & facility affiliations 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1407866056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 N CENTRAL EXPY",
            "address_2": "#600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752043147",
            "telephone_number": "214-520-5743",
            "fax_number": "214-520-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N BECKLEY AVE",
            "address_2": "MMC DALLAS",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75203",
            "telephone_number": "214-942-5733",
            "fax_number": "214-942-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSON",
        "first_name": "ROBERT",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G0121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE SHIELD",
            "identifier": "82951F",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133941802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.