Individual provider Active NPI

Mazvita Ethel Simoyi, MD

  • Surgery Physician
  • Lake Wales, FL
National Provider Identifier
1578980751
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME140906 Issued in FL
Practice address
425 S 11TH St
Lake Wales, FL 33853-4239
Phone
(844) 634-3627
Fax
(863) 676-3621
NPI assigned
Mar 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME140906 FL Primary

Addresses

Primary practice location

425 S 11TH St
Lake Wales, FL 33853-4239

Mailing address

425 S 11TH St
Lake Wales, FL 33853-4239
Phone (844) 634-3627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200819003068 FL Practitioner - General SurgeryPractitioner - Family PracticePractitioner - Peripheral Vascular Disease 7618195058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Virginia School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Florida Trauma Network, LLCGroup PAC ID 7911175658, 14 clinicians

Practice addresses (Care Compare)

2010 59TH St W
Suite 2200
Bradenton, FL 34209-4689
Phone (941) 794-5621

Hospital & facility affiliations

  • HCA Florida Healthcare at Home Home health agency, Bradenton, FL, CCN 107656
  • HCA Florida Blake Hospital Hospital, Bradenton, FL, CCN 100213
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

Merit-based Incentive Payment System (MIPS)

Final score
97.62 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
76.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME140906FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Florida Trauma Network, LLC CurrentSince Oct 1, 2023 Accepting new patients
West Florida Cardiology Network, LLC Past Accepting new patients

Locations

315 75th St W
Bradenton, FL 34209
Phone (941) 761-1616

2010 59th St W
Ste 1600
Bradenton, FL 34209
Phone (941) 794-5621

2010 59th St W
Bradenton, FL 34209
Phone (813) 453-0590

2010 59th St W
Ste 1700
Bradenton, FL 34209
Phone (941) 752-2789

2010 59th St W
Ste 2200
Bradenton, FL 34209
Phone (941) 794-5621

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4692/brand/27/csg/1/fhir/r4
  • Direct secure messaging: mazvita.simoyi@hca4.eclinicaldirectplus.com

Organizations & group practices 2

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 3

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": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1578980751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534239",
            "telephone_number": "844-634-3627",
            "fax_number": "863-676-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534239",
            "telephone_number": "844-634-3627",
            "fax_number": "863-676-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMOYI",
        "first_name": "MAZVITA",
        "middle_name": "ETHEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME140906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

Verify at the official NPI Registry.