Individual provider Active NPI

Jeremy Rosenbaum Simon, MD

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1417982869
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
204243 Issued in NY
Practice address
Columbia University Med Center
622 W 168 Street PH 1-137
New York, NY 10032-3784
Phone
(212) 305-2995
Fax
(212) 305-6792
NPI assigned
Jul 12, 2006
Reactivated
Oct 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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 204243 NY Primary

Addresses

Primary practice location

Columbia University Med Center
622 W 168 Street PH 1-137
New York, NY 10032-3784

Mailing address

622 W 168TH St # VC2-260
New York, NY 10032-3784
Phone (212) 305-2995

Other identifiers 1

IdentifierTypeStateIssuer
D1936227MedicaidNY

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address jes9014@direct.nyp.org Direct
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414001742 NY Practitioner - Emergency Medicine 0244225852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, shared by 10 NPIs, 2,262 clinicians

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204243NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Jan 2, 2017 Accepting new patients
Trustees of Columbia University in the City of New York Emergency Medicine CurrentSince Jan 2, 2017 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Sep 12, 2018 Accepting new patients

Locations

622 W 168th St
Ph 1137
New York, NY 10032
Phone (212) 305-2575

622 W 168th St
Ste PHI137
New York, NY 10032

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
#2260
New York, NY 10032
Phone (212) 305-6204

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1417982869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST # VC2-260",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323784",
            "telephone_number": "212-305-2995",
            "fax_number": "212-305-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COLUMBIA UNIVERSITY MED CENTER",
            "address_2": "622 W 168 STREET PH 1-137",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323784",
            "telephone_number": "212-305-2995",
            "fax_number": "212-305-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM SIMON",
        "first_name": "JEREMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "deactivation_date": "2006-07-19",
        "reactivation_date": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "204243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D1936227",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "Columbia University Med Center",
            "address_2": "622 W 168 Street PH 1-137",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100323784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jes9014@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "Columbia University Med Center",
            "address_2": "622 W 168 Street PH 1-137",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100323784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "Columbia University Med Center",
            "address_2": "622 W 168 Street PH 1-137",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100323784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.