NPIMap

Individual provider Active NPI

Herold Simon

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1427034974
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
175968 Issued in NY
Practice address
672 Utica Ave
Brooklyn, NY 11203-2210
Phone
(718) 940-0400
Fax
(718) 940-8327
NPI assigned
Dec 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 175968 NY
Internal Medicine Physician 207R00000X 175968 NY Primary

Addresses

Primary practice location

672 Utica Ave
Brooklyn, NY 11203-2210

Mailing address

328 Arkansas Dr
Valley Stream, NY 11580-1804
Phone (516) 561-3040

Other identifiers 1

IdentifierTypeStateIssuer
01191588MedicaidNY

Other names 1

  • Herold Simon Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110104000811 NY Practitioner - Internal MedicinePractitioner - Nephrology 0042409278 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

672 Utica Ave
Brooklyn, NY 11203-2210
Phone (718) 940-0400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as apm
Quality
79.86
Promoting interoperability
88.89
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
175968NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Herold Simon Medical Services, PLLC Nephrology CurrentSince Feb 24, 2014 Accepting new patients
Block Institute, Inc. Past Accepting new patients
Oxford Nursing Home, Inc Past Accepting new patients
Block Institute, Inc. Past Accepting new patients
Block Institute, Inc. Past Accepting new patients
Ditmas Park Rehabilitation & Care Center LLC Past Accepting new patients
Park Slope Medical Service PC Past Accepting new patients

Locations

672 Utica Ave
Brooklyn, NY 11203
Phone (718) 221-9999

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: herold.simon.1@8629.direct.athenahealth.com

Organizations & group practices 7

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 4

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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1427034974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 ARKANSAS DR",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801804",
            "telephone_number": "516-561-3040",
            "fax_number": "718-240-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 UTICA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032210",
            "telephone_number": "718-940-0400",
            "fax_number": "718-940-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "HEROLD",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "175968",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "175968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01191588",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEROLD",
            "last_name": "SIMON",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.