Organization Active NPI

Peter J Simon MD PA

Doing business as Peter J. Simon MD

  • Plastic Surgery Physician
  • Fort Lauderdale, FL
National Provider Identifier
1467467027
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME0051739 Issued in FL
Legal business name
PETER J SIMON MD PA
Doing business as
Peter J. Simon MD
Practice address
3201 N Federal Hwy
Suite 302
Ft Lauderdale, FL 33306
Phone
(954) 568-1010
Fax
(954) 568-0566
NPI assigned
Jul 30, 2006
Last updated
Feb 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Authorized official

Name
Dr. Peter J Simon, MDNPI 1518974823
Title
President
Phone
(954) 568-1010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X ME0051739 FL Primary

Addresses

Primary practice location

3201 N Federal Hwy
Suite 302
Ft Lauderdale, FL 33306

Mailing address

3201 N Federal Hwy
Suite 302
Ft Lauderdale, FL 33306
Phone (954) 568-1010

Other names 1

  • Peter J. Simon MD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120925000238 FL Part B Supplier - Clinic/Group Practice 7618126202 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Lauderdale, FL

National Provider Directory

National Provider Directory

Locations

3201 N Federal Hwy
Ste 302
Ft Lauderdale, FL 33306
Phone (305) 568-1010

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1467467027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 N FEDERAL HWY",
            "address_2": "SUITE 302",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "33306",
            "telephone_number": "954-568-1010",
            "fax_number": "954-568-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 N FEDERAL HWY",
            "address_2": "SUITE 302",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "33306",
            "telephone_number": "954-568-1010",
            "fax_number": "954-568-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER J SIMON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-568-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME0051739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peter J. Simon MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.