Individual provider Active NPI

Clifford Simon, MD

  • Internal Medicine Physician
  • Englewood, NJ
National Provider Identifier
1487668299
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA03058000 Issued in NJ
Practice address
180 Engle St
Englewood, NJ 07631-2507
Phone
(201) 567-2050
Fax
(201) 567-5070
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA03058000 NJ Primary
Pulmonary Disease Physician 207RP1001X 25MA03058000 NJ

Addresses

Primary practice location

180 Engle St
Englewood, NJ 07631-2507

Mailing address

180 Engle St
Englewood, NJ 07631-2507
Phone (201) 567-2050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100622000047 NJ Practitioner - Internal MedicinePractitioner - Pulmonary Disease 3870697261 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03058000NJMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC Internal Medicine CurrentSince Apr 1, 2013 Accepting new patients

Locations

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

Interoperability endpoints

  • Direct secure messaging: csimon236770@direct.englewoodhealth.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1487668299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312507",
            "telephone_number": "201-567-2050",
            "fax_number": "201-567-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312507",
            "telephone_number": "201-567-2050",
            "fax_number": "201-567-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03058000",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA03058000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.