Individual provider Active NPI

Sotiria Simeonidis, PA-C

  • Surgical Physician Assistant
  • Bronxville, NY
National Provider Identifier
1548783939
Registry record updated Nov 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
020987 Issued in NY
Practice address
55 Palmer Ave
Bronxville, NY 10708-3403
Phone
(914) 787-1000
NPI assigned
Jul 18, 2017
Last updated
Nov 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 020987 NY Primary

Addresses

Primary practice location

55 Palmer Ave
Bronxville, NY 10708-3403

Mailing address

32 Jefferson St
Nutley, NJ 07110-3122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171205002759 NY Practitioner - Physician Assistant 1254698939 Reassigns benefits to 2 organizations
I20200526002429 NJ Practitioner - Physician Assistant 1254698939 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence Medical Associates, PC CurrentSince Oct 16, 2017 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 29, 2020 Accepting new patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Aug 29, 2020 Accepting new patients

Locations

55 Palmer Ave
Bronxville, NY 10708
Phone (914) 787-3136

685 White Plains Rd
Fl 2
Eastchester, NY 10709
Phone (914) 787-4100

685 White Plains Rd
Lowr
Eastchester, NY 10709
Phone (914) 787-4100

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761955200000",
    "number": "1548783939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 JEFFERSON ST",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PALMER AVE",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107083403",
            "telephone_number": "914-787-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMEONIDIS",
        "first_name": "SOTIRIA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2025-11-01",
        "certification_date": "2025-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "020987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronxville, NY

Sources for this page

Verify at the official NPI Registry.