Clark Jeffrey Simons, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

01052784A Issued in IN

Practice address

1001 W 10TH St BLDG 1014
Indianapolis, IN 46202-2859

Phone

(317) 630-6623

NPI assigned

May 3, 2006

Last updated

Nov 16, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

General Surgery

Education

State University of Ny Upstate Medical University, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

University Surgeons IncGroup PAC ID 9436171949, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eskenazi Health Hospital, Indianapolis, IN, CCN 150024

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: csimons@direct.iuhealth.org
• Direct secure messaging: csimons15558@direct.eskenazihealth.edu

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.

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• University Surgeons, Inc.

  • Surgery Physician
  • Indianapolis, IN
  • NPI 1316966229
  Medicare reassignment Care Compare group NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• University General Surgeons, Inc.

  • Surgery Physician
  • Indianapolis, IN
  • NPI 1811019847
  NPD (past)

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

• The Health and Hospital Corporation of Marion County

  dba Eskenazi Health

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1568407310
  Care Compare affiliation
• The Health and Hospital Corporation of Marion County

  dba Eskenazi Health Midtown Narcotics Treatment Program

  • Methadone Clinic
  • Indianapolis, IN
  • NPI 1760922249

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1437117082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-963-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W 10TH ST BLDG 1014",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022859",
            "telephone_number": "317-630-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "CLARK",
        "middle_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01052784A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000386164",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200291970",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csimons@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1001 W 10th St Bldg 1014",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462022859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nathan Simon, MD
• Neal P Simon, MD
• Rosalineda Simon, RBT
• Sadie Elizabeth Simon
• Linas Simonaitis
• Tayler Simons, DO
• Peter Thomas Simonse, DO
• Adam David Simonsen, D.O.
• Kijah Simonton
• Tyler B Simonton, PA-C

• Surgery Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.