Individual provider Active NPI

Alphi Josy Simon, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1659863769
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95008680 Issued in CA
Practice address
1993 McKee Rd
San Jose, CA 95116-1406
Phone
(408) 885-5000
NPI assigned
Jun 4, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95008680 CA Primary

Addresses

Primary practice location

1993 McKee Rd
San Jose, CA 95116-1406

Mailing address

37443 Joseph St
Fremont, CA 94536-4910
Phone (510) 713-2362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181010002756 CA Practitioner - Nurse Practitioner 5092067553 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95008680CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jul 30, 2018 Accepting new patients
County of Santa Clara CurrentSince Jul 30, 2018 Accepting new patients
County of Santa Clara Current Accepting new patients

Locations

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1659863769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37443 JOSEPH ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364910",
            "telephone_number": "510-713-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1993 MCKEE RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161406",
            "telephone_number": "408-885-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSY SIMON",
        "first_name": "ALPHI",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95008680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.