NPIMap

Individual provider Active NPI

Samuel McDonald Simkoff, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1548032386
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4010957 Issued in KY
Practice address
1720 W Broadway Ste 107
Louisville, KY 40203-3607
Phone
(502) 340-5900
NPI assigned
Oct 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4010957 KY Primary

Addresses

Primary practice location

1720 W Broadway Ste 107
Louisville, KY 40203-3607

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 559-9407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240102000583 KY Practitioner - Nurse Practitioner 2668822776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

1720 W Broadway
Suite 107
Louisville, KY 40203-3607
Phone (502) 340-5900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4010957KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Family Medicine CurrentSince Jan 1, 2024 Accepting new patients
Community Medical Associates, Inc. Family Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

1720 W Broadway
Ste 107
Louisville, KY 40203
Phone (502) 340-5900

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

315 E Broadway
Louisville, KY 40202
Phone (502) 272-5331

Interoperability endpoints

  • Direct secure messaging: ssimkoff280798@direct.nortonhealthcare.org

Organizations & group practices 3

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1548032386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-559-9407",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 W BROADWAY STE 107",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402033607",
            "telephone_number": "502-340-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMKOFF",
        "first_name": "SAMUEL",
        "middle_name": "MCDONALD",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4010957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.