Individual provider Active NPI

Jessica Simon, M.D

  • Specialist
  • East Windsor, NJ
National Provider Identifier
1659651099
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2MA09671000 Issued in NJ
Practice address
59 One Mile Rd Ext Ste G
East Windsor, NJ 08520-2505
Phone
(609) 443-4500
NPI assigned
Aug 17, 2011
Last updated
Oct 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2MA09671000 NJ Primary
Dermatology Physician 207N00000X TRN16566 FL

Addresses

Primary practice location

59 One Mile Rd Ext Ste G
East Windsor, NJ 08520-2505

Mailing address

59 One Mile Road Ext Suite G
East Windsor, NJ 08520
Phone (609) 443-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20151023000701 NJ Practitioner - Dermatology 1052533759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rutgers School of Dental Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SDG Dermatology PCGroup PAC ID 1759745789, 6 clinicians

Practice addresses (Care Compare)

59 One Mile Rd Ext
Suite B
East Windsor, NJ 08520-2505
Phone (609) 443-4500

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision30
Removal of skin lesions893
Skin biopsy428

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2MA09671000NJMDSpecialist
TRN16566FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SDG Dermatology PC Dermatology CurrentSince Jun 1, 2023 Accepting new patients
Hightstown Medical Associates PA Past Accepting new patients

Locations

59 One Mile Rd Ext
East Windsor, NJ 08520
Phone (609) 443-1150

59 One Mile Rd Ext
Ste B
East Windsor, NJ 08520
Phone (609) 443-4500

59 One Mile Rd Ext
Ste G
East Windsor, NJ 08520
Phone (609) 443-4500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1659651099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 ONE MILE ROAD EXT SUITE G",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "08520",
            "telephone_number": "609-443-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 ONE MILE RD EXT STE G",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "085202505",
            "telephone_number": "609-443-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "2MA09671000",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "TRN16566",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Windsor, NJ

Sources for this page

Verify at the official NPI Registry.