Individual provider Active NPI

Hannah Lynn Simon, PA-C

  • Physician Assistant
  • Erie, PA
National Provider Identifier
1477857985
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA054588 Issued in PA
Practice address
2315 Myrtle St Ste 290
Erie, PA 16502-4602
Phone
(814) 452-7300
Fax
(814) 452-5015
NPI assigned
Dec 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA054588 PA Primary

Addresses

Primary practice location

2315 Myrtle St Ste 290
Erie, PA 16502-4602

Mailing address

2315 Myrtle St Ste 290
Erie, PA 16502-4609
Phone (814) 452-7300

Other identifiers 2

IdentifierTypeStateIssuer
12184218OtherCAQH
103201598MedicaidPA

Other names 1

  • Ms. Hannah Lynn Koenig Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hsimon148945@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110413000717 PA Practitioner - Physician Assistant 0840474961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Education and Research Institute IncGroup PAC ID 3870405137, 297 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

155 E State St
Albion Family Practice
Albion, PA 16401-1347
Phone (814) 756-4917

232 W 25TH St
Erie, PA 16544-0002

312 W 25TH St
Ahn Saint Vincent Anesthesia
Erie, PA 16502-2624
Phone (814) 452-7000

4247 W Ridge Rd
Erie, PA 16506-1746

7015 Beracasa Way
Cora Physical Therapy W Boca Raton
Boca Raton, FL 33433-3453
Phone (561) 939-2033

Hospital & facility affiliations

  • Saint Vincent Hospital Hospital, Erie, PA, CCN 390009

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Services Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hsimon148945@direct.ahn.org

Organizations & group practices 2

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 1

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": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1477857985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE 290",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024609",
            "telephone_number": "814-452-7300",
            "fax_number": "814-452-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE 290",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024602",
            "telephone_number": "814-452-7300",
            "fax_number": "814-452-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "HANNAH",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12184218",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103201598",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hsimon148945@direct.ahn.org",
            "affiliation": "N",
            "address_1": "2315 Myrtle St Ste 290",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165024602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "KOENIG",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.