NPIMap

Individual provider Active NPI

Steven James Simerville, MD

  • Pediatrics Physician
  • Pueblo West, CO
National Provider Identifier
1497712921
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DR.0044566 Issued in CO
Practice address
109 S Burlington Dr
Pueblo West, CO 81007-5560
Phone
(719) 595-6020
Fax
(933) 373-1043
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X DR.0044566 CO
Pediatrics Physician 208000000X DR.0044566 CO Primary

Addresses

Primary practice location

109 S Burlington Dr
Pueblo West, CO 81007-5560

Mailing address

PO Box 9000
Pueblo, CO 81008-9000
Phone (719) 553-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20060613000326 CO Practitioner - Internal MedicinePractitioner - Pediatric Medicine 7012955354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Georgetown University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Colorado Clinic PCGroup PAC ID 4284524067, 36 clinicians

Practice addresses (Care Compare)

109 S Burlington Dr
Pueblo West, CO 81007-5549
Phone (719) 553-2200

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Colorado Springs, CO, CCN 067449
  • Frontier Home Health LLC Home health agency, Pueblo, CO, CCN 067501
  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020
  • St Mary-Corwin Hospital Hospital, Pueblo, CO, CCN 060012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0044566COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Colorado Clinic PC Multi-Specialty CurrentSince Apr 12, 2021 Accepting new patients

Locations

3676 Parker Blvd
Ste 290
Pueblo, CO 81008
Phone (719) 553-2200

1008 Minnequa Ave
Pueblo, CO 81004
Phone (719) 557-5656

109 S Burlington Dr
Pueblo West, CO 81007
Phone (719) 766-9000

Interoperability endpoints

  • Direct secure messaging: steven.simerville.1@21306.direct.athenahealth.com

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.

Hospital & facility affiliations 12

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1497712921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9000",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810089000",
            "telephone_number": "719-553-2200",
            "fax_number": "833-373-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S BURLINGTON DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810075560",
            "telephone_number": "719-595-6020",
            "fax_number": "933-373-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMERVILLE",
        "first_name": "STEVEN",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0044566",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0044566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo West, CO

Sources for this page

Verify at the official NPI Registry.