NPIMap

Individual provider Active NPI

Hi Sup Sim, M.D.

  • Internal Medicine Physician
  • Havre de Grace, MD
National Provider Identifier
1659320505
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0046412 Issued in MD
Practice address
251 Lewis Lane
Suite 201
Havre de Grace, MD 21078-3753
Phone
(410) 939-4477
Fax
(410) 939-1153
NPI assigned
May 9, 2006
Last updated
Feb 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X D0046412 MD
Internal Medicine Physician 207R00000X D0046412 MD Primary

Addresses

Primary practice location

251 Lewis Lane
Suite 201
Havre de Grace, MD 21078-3753

Mailing address

251 Lewis Lane
Suite 201
Havre de Grace, MD 21078-3753
Phone (410) 939-4477

Other identifiers 7

IdentifierTypeStateIssuer
145388000OtherMDWCDL
W724002OtherMDDELMARVA HEALTH PLAN
000424675OtherPABS OF PA
10199000000OtherMDPHN
148241600MedicaidMD
W724002OtherDCBS OF DC
52386701OtherMDBS OF MD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20110425000675 MD Practitioner - Internal Medicine 7012932338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
DRS Biondo and Sim PAGroup PAC ID 4082681689, 4 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

251 Lewis LN
Suite 201
Havre de Grace, MD 21078-3753
Phone 4436166236317

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
30.97 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
76.61

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0046412MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Nursing Home Board of Harford County Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hi.sim.1@32478.direct.athenahealth.com

Organizations & group practices 3

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 9

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1659320505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 LEWIS LANE",
            "address_2": "SUITE 201",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783753",
            "telephone_number": "410-939-4477",
            "fax_number": "410-939-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 LEWIS LANE",
            "address_2": "SUITE 201",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783753",
            "telephone_number": "410-939-4477",
            "fax_number": "410-939-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIM",
        "first_name": "HI",
        "middle_name": "SUP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MD",
            "license": "D0046412",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0046412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WCDL",
            "identifier": "145388000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELMARVA HEALTH PLAN",
            "identifier": "W724002",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF PA",
            "identifier": "000424675",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHN",
            "identifier": "10199000000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148241600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF DC",
            "identifier": "W724002",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF MD",
            "identifier": "52386701",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

Verify at the official NPI Registry.