Active NPI
Bradley Eric Simon, MD
- Emergency Medicine Physician
- Lakewood, CO
National Provider Identifier
1689695256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 35183
- Practice address
- 11600 W 2ND PL
St. Anthony Hospital, Emergency Dept.
Lakewood, CO 80228-1527 - Phone
- (720) 321-4161
- Fax
- (720) 321-4165
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 35183 | CO | Primary |
Addresses
Primary practice location
11600 W 2ND PL
St. Anthony Hospital, Emergency Dept.
Lakewood, CO 80228-1527
Mailing address
PO Box 5788
Denver, CO 80217-5788
Phone (720) 979-8969
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7717960 | Medicaid | SD | |
| S2077 | Medicaid | NM | |
| 01351832 | Medicaid | CO | |
| 8472334 | Medicaid | WA | |
| P00384488 | Other | CO | RR MEDICARE |
| 200384180A | Medicaid | KS | |
| 122709200 | Medicaid | WY | |
| Z3274 | Medicaid | UT | |
| 143705 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375315200000",
"number": "1689695256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5788",
"city": "DENVER",
"state": "CO",
"postal_code": "802175788",
"telephone_number": "720-979-8969",
"fax_number": "303-202-1281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11600 W 2ND PL",
"address_2": "ST. ANTHONY HOSPITAL, EMERGENCY DEPT.",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802281527",
"telephone_number": "720-321-4161",
"fax_number": "720-321-4165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "BRADLEY",
"middle_name": "ERIC",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2013-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "35183",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7717960",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "S2077",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01351832",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8472334",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00384488",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200384180A",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "122709200",
"state": "WY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Z3274",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "143705",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.