Michael Gerard Simon, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00987000 Issued in NJ

Practice address

114 Hayes Mill Rd
Atco, NJ 08004-2457

Phone

(856) 809-7242

Fax

(856) 809-7269

NPI assigned

Aug 29, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Rehab Somerset PAGroup PAC ID 0547540809, 57 clinicians

Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jag-One Physical Therapy, LLC

  • Physical Therapist
  • West Orange, NJ
  • NPI 1518017144
  Medicare reassignment Care Compare group NPD
• Trinity Rehab Somerset PA

  • Physical Therapist
  • Somerset, NJ
  • NPI 1245789064
  Medicare reassignment Care Compare group
• Trinity Rehab Somerset PA

  • Physical Medicine & Rehabilitation Physician
  • Clifton, NJ
  • NPI 1609489954
  NPD
• Trinity Rehab Somerset PA

  • Physical Therapy Clinic/Center
  • North Wales, PA
  • NPI 1144892852
  NPD

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1699256420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 GREENTREE RD STE 110",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031130",
            "telephone_number": "856-528-5360",
            "fax_number": "856-520-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 HAYES MILL RD",
            "city": "ATCO",
            "state": "NJ",
            "postal_code": "080042457",
            "telephone_number": "856-809-7242",
            "fax_number": "856-809-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "MICHAEL",
        "middle_name": "GERARD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00987000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shana Sandrow, D.C.
• Chad Brian Scott
• Stephanie L Serrano, MS, OTR/L
• Lucy Shade, RPH
• Amber Simmons
• Rashawn Smith
• Rosemarie Smith, MS, CCC-SLP
• Dawn Stone, MPT
• The Woodlands at Hayes Mill
• The Woodlands at Hayes Mill, LLC

• Physical Therapist in Atco, NJ
• Providers in Atco, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.