Simon J. McCoy, D.P.M
Individual provider Active NPI Podiatrist · Harbor Beach, MI
NPI 1417286121 · NPPES record last updated Feb 14, 2024
Key facts
- NPI
- 1417286121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Podiatrist 213E00000X
- License
- 5901002343 (MI)
- Practice address
- 219 State St
Harbor Beach, MI 48441-1206 - Phone
- (810) 535-5507
- Fax
- (810) 535-5578
- NPI assigned
- Dec 9, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Kent State University College of Podiatric Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
219 State St
Harbor Beach, MI 48441-1206
Phone (810) 535-5507
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 357 |
| Removal or shaving of skin growth | 327 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121030000011 | MI | Practitioner - Podiatry | 2264682277 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5901002343 | MI | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Portable Podiatry PLLC | Podiatrist | Current |
Accepting new patients |
| Gerald F Daneshvar MD PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 5901002343 | MI | |
| Podiatrist | 213E00000X | 5901002343 | MI | Yes |
Addresses
Primary practice location
219 State St
Harbor Beach, MI 48441-1206
Mailing address
PO Box 282
Harbor Beach, MI 48441-0282
Phone (810) 535-5507
Other names
- Dr. S. James McCoy
Other providers in Harbor Beach, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.