Mark Stefan James Simkow, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704285727 Issued in MI

Practice address

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Phone

(313) 593-7000

NPI assigned

Jul 18, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020

Merit-based Incentive Payment System (MIPS)

Final score

84.37 of 100Reported as group

Quality

66.73

Promoting interoperability

100

Improvement activities

40

Cost

70.98

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msimkow119673@direct.beaumont.edu
• Direct secure messaging: msimkow1256009@epic00.shdirect.org

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Oakwood Healthcare Inc

  • Community Health Clinic/Center
  • Dearborn, MI
  • NPI 1790414670

  Hospital

  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  Care Compare affiliation

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1508546375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "475-221-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMKOW",
        "first_name": "MARK",
        "middle_name": "STEFAN JAMES",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704285727",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704285727",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704285727",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msimkow119673@direct.beaumont.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "18101 Oakwood Blvd",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481244089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Oscar Signori, MD
• Adina Siklawi, NP
• Silberg-Waterworks PC
• Eric T Silberg, M.D.
• Silver Physical Therapy LLC
• Augusta Simmons, OTR,CHT
• Ayana Kafi Simmons, PSYD, LP
• Nevaeh Skye Simms
• Nicole Simms
• Simon Community Transportation, Inc

• Acute Care Nurse Practitioner in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.