Individual provider Active NPI

Robert H Simmonds, DPM

  • Podiatrist
  • Syracuse, NY
National Provider Identifier
1609955962
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N002920-1 Issued in NY
Practice address
3309 James Street
Syracuse, NY 13206
Phone
(315) 463-0991
Fax
(315) 463-0885
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N002920-1 NY Primary

Addresses

Primary practice location

3309 James Street
Syracuse, NY 13206

Mailing address

3309 James Street
Syracuse, NY 13206

Other identifiers 1

IdentifierTypeStateIssuer
00400986MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N002920-1NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Simmonds,Brady&Loi Oral and Maxillofacial Surgery and Implant Speciali Past Accepting new patients
James Street Dental Arts, PC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1609955962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 JAMES STREET",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 JAMES STREET",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13206",
            "telephone_number": "315-463-0991",
            "fax_number": "315-463-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONDS",
        "first_name": "ROBERT",
        "middle_name": "H",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N002920-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00400986",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.