NPIMap

Individual provider Active NPI

Ellen M Simon, M.D.

  • Cardiovascular Disease Physician
  • Brunswick, ME
National Provider Identifier
1649227331
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD16225 Issued in ME
Practice address
121 Medical Center Dr
Suite 3100
Brunswick, ME 04011-2653
Phone
(207) 729-7939
Fax
(207) 725-4717
NPI assigned
May 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 160838 MA
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 160838 MA
Cardiovascular Disease Physician 207RC0000X MD16225 ME Primary

Addresses

Primary practice location

121 Medical Center Dr
Suite 3100
Brunswick, ME 04011-2653

Mailing address

121 Medical Center Dr
Suite 3100
Brunswick, ME 04011-2653
Phone (207) 729-7939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040421000552 ME Practitioner - Cardiovascular Disease (Cardiology) 4789670340 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Massachusetts Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

121 Medical Ctr Dr
Suite 3100
Brunswick, ME 04011-2672
Phone (207) 729-7939

22 Bramhall St
Portland, ME 04102-3134

24 Miles Ctr Way
Maine Behavioral Healthcare
Damariscotta, ME 04543-4067
Phone (844) 292-0111

5 Miles Ctr Way
Damariscotta, ME 04543-4067
Phone (207) 563-3782

Hospital & facility affiliations

  • Mainehealth Mid Coast Hospital Hospital, Brunswick, ME, CCN 200021
  • Lincolnhealth Hospital, Damariscotta, ME, CCN 201302
  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
160838MAMDCardiovascular Disease Physician
MD16225MEMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Dec 1, 2020 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince Jan 1, 2021 Accepting new patients
Mainehealth CurrentSince Dec 1, 2020 Accepting new patients
Maine Medical Partners Cardiovascular Disease CurrentSince Jan 1, 2021 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Current Accepting new patients
Mainehealth Past Accepting new patients

Locations

123 Medical Center Dr
Brunswick, ME 04011
Phone (207) 373-6800

121 Medical Center Dr
Ste 3100
Brunswick, ME 04011
Phone (207) 729-7939

24 Miles Center Way
#1
Damariscotta, ME 04543

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

887 Congress St
Ste 200
Portland, ME 04102
Phone (207) 771-5549

Interoperability endpoints

  • Direct secure messaging: esimon356653@direct.mmc.mainehealth.org

Organizations & group practices 8

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 38

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1649227331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MEDICAL CENTER DR",
            "address_2": "SUITE 3100",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112653",
            "telephone_number": "207-729-7939",
            "fax_number": "207-725-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 MEDICAL CENTER DR",
            "address_2": "SUITE 3100",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112653",
            "telephone_number": "207-729-7939",
            "fax_number": "207-725-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "ELLEN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "160838",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MA",
            "license": "160838",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ME",
            "license": "MD16225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.