Individual provider Active NPI

Cassandra Joy Simonetta, M.D.

  • Dermatology Physician
  • State College, PA
National Provider Identifier
1508203811
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD464450 Issued in PA
Practice address
32 Colonnade Way
State College, PA 16803
Phone
(814) 272-4445
Fax
(814) 272-4450
NPI assigned
May 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD464450 PA Primary

Addresses

Primary practice location

32 Colonnade Way
State College, PA 16803

Mailing address

PO Box 858
MC A410
Hershey, PA 17033-0858
Phone (800) 243-1455

Other identifiers 1

IdentifierTypeStateIssuer
677344OtherPAMEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180710003606 PA Practitioner - Dermatology 9830322338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Saint Louis University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Milton S Hershey Medical Center Physicians GroupGroup PAC ID 3870405483, 1,606 clinicians

Practice addresses (Care Compare)

500 Universidy Dr
A410
Hershey, PA 17033-2360
Phone (717) 531-8307

Hospital & facility affiliations

  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision39
Removal of skin lesions40
Removal of skin cancer252
Removal of nail tissue1-10
Skin biopsy44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physician Group CurrentSince Jul 1, 2018 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
The Milton S Hershey Medical Center Physicians Group Dermatology CurrentSince Jul 1, 2018 Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Dermatology Past Accepting new patients

Locations

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
#A4
Hershey, PA 17033
Phone (717) 531-6261

32 Colonnade Way
State College, PA 16803
Phone (717) 531-5164

303 Benner Pike
Ste 1
State College, PA 16801
Phone (814) 272-5660

Organizations & group practices 4

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": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1508203811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 COLONNADE WAY",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "16803",
            "telephone_number": "814-272-4445",
            "fax_number": "814-272-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONETTA",
        "first_name": "CASSANDRA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD464450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "677344",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.