NPIMap

Individual provider Active NPI

Daniel J Simon, PA

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1639471667
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9081204 Issued in ID
Practice address
212 E Central Ave
Suite 440
Spokane, WA 99208-6291
Phone
(509) 489-2600
Fax
(509) 789-9064
NPI assigned
Nov 24, 2010
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 9081204 ID Primary
Physician Assistant 363A00000X BG60555472 WA

Addresses

Primary practice location

212 E Central Ave
Suite 440
Spokane, WA 99208-6291

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other practice location 1

425 W Bannock St
Boise, ID 83702-6035
Phone (208) 343-6458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150427000653 WA Practitioner - Physician Assistant 7113108200 Reassigns benefits to 1 organization
I20260324004053 ID Practitioner - Physician Assistant 7113108200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Idaho Gastroenterology Associates LLPGroup PAC ID 6002708773, 35 clinicians

Practice addresses (Care Compare)

1200 Garrity Blvd
Nampa, ID 83687-3402
Phone (208) 489-1431

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9081204IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Nov 15, 2015 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

105 W 8th Ave
Ste 7050
Spokane, WA 99204
Phone (509) 252-1711

212 E Central Ave
Ste 440
Spokane, WA 99208
Phone (509) 252-1977

105 W 8th Ave
Ste 6045
Spokane, WA 99204
Phone (509) 455-3676

212 E Central Ave
Ste 245
Spokane, WA 99208
Phone (509) 252-1977

101 W 8th Ave
Ste 100
Spokane, WA 99204
Phone (509) 474-2880

16528 E Desmet Ct
Ste A2200
Spokane Valley, WA 99216
Phone (509) 489-6995

Interoperability endpoints

  • Direct secure messaging: dsimon512626@wm.providencedirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1290556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1639471667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E CENTRAL AVE",
            "address_2": "SUITE 440",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086291",
            "telephone_number": "509-489-2600",
            "fax_number": "509-789-9064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 W Bannock St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837026035",
            "country_code": "US",
            "telephone_number": "208-343-6458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-24",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "9081204",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "BG60555472",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.