Individual provider Active NPI

Jessie Mae Simmon, MD

  • Obstetrics & Gynecology Physician
  • Albuquerque, NM
National Provider Identifier
1558715003
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD2020-0647 Issued in NM
Practice address
1100 Central Avenue SE Suite 5600
OBGYN Hospitalist
Albuquerque, NM 87106-4920
Phone
(505) 841-0922
Fax
(505) 563-6380
NPI assigned
Apr 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X MD2020-0647 NM Primary

Addresses

Primary practice location

1100 Central Avenue SE Suite 5600
OBGYN Hospitalist
Albuquerque, NM 87106-4920

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666

Other identifiers 1

IdentifierTypeStateIssuer
MD2020-0647OtherNMLICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200811000312 NM Practitioner - Obstetrics/Gynecology 8123443983 Reassigns benefits to 2 organizations
I20221004003333 TX Practitioner - Obstetrics/Gynecology 8123443983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians
Kewa Pueblo Health CorporationGroup PAC ID 7618137779, 29 clinicians

Practice addresses (Care Compare)

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1234

4705 Montgomery Blvd NE
Suite 301
Albuquerque, NM 87109-1234
Phone (505) 727-4500

85 W Hwy 22
Santo Domingo Pueblo, NM 87052-1283
Phone (505) 465-3060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2020-0647NMMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Single Specialty CurrentSince Jun 22, 2025 Accepting new patients
Presbyterian Healthcare Services Single Specialty CurrentSince Jun 22, 2025 Accepting new patients
Southwest Medical Associates, LLC Single Specialty CurrentSince Sep 8, 2020 Accepting new patients
Kewa Pueblo Health Corporation Single Specialty CurrentSince Sep 20, 2022 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Sep 8, 2020 Accepting new patients
Lovelace Health System, LLC Past Accepting new patients
Kewa Pueblo Health Corporation Past Accepting new patients

Locations

4705 Montgomery Blvd NE
Ste 301
Albuquerque, NM 87109
Phone (505) 727-4500

1100 Central Ave SE
Ste 5600
Albuquerque, NM 87106
Phone (505) 841-0922

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

201 Cedar St SE
Ste 5600
Albuquerque, NM 87106
Phone (505) 554-7836

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

85 W Highway 22
Santo Domingo Pueblo, NM 87052
Phone (505) 465-3060

Interoperability endpoints

  • Direct secure messaging: jsimmon270013@direct.phs.org
  • Direct secure messaging: jessie.simmon.p1@direct.kp-hc.nextgenshare.com

Organizations & group practices 7

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 2

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1558715003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVENUE SE SUITE 5600",
            "address_2": "OBGYN HOSPITALIST",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064920",
            "telephone_number": "505-841-0922",
            "fax_number": "505-563-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMON",
        "first_name": "JESSIE",
        "middle_name": "MAE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "MD2020-0647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "MD2020-0647",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.