Individual provider Active NPI

Jeffrey M De Simone, MD

  • Surgery Physician
  • Syracuse, NY
National Provider Identifier
1699726737
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
172879 Issued in NY
Practice address
739 Irving Ave
Suite 450
Syracuse, NY 13210-1651
Phone
(315) 470-7364
Fax
(315) 470-5859
NPI assigned
May 13, 2006
Last updated
Apr 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 172879 NY Primary

Addresses

Primary practice location

739 Irving Ave
Suite 450
Syracuse, NY 13210-1651

Mailing address

1001 W Fayette St Ste 400
Syracuse, NY 13204-2866
Phone (315) 937-3433

Other identifiers 1

IdentifierTypeStateIssuer
01482200MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jeffreydesimone@crousemed.medentdirect.com Direct Crouse Medical Practice, PLLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051208000288 NY Practitioner - General Surgery 8820019631 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Georgetown University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Care PCGroup PAC ID 9032367453, 74 clinicians
Claxton-Hepburn Medical CenterGroup PAC ID 8426966508, 78 clinicians
Carthage Area Hospital IncGroup PAC ID 9931010485, shared by 16 NPIs, 119 clinicians
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

140 W 6TH St
Suite LL30
Oswego, NY 13126-2525
Phone (315) 349-5822

214 King St
Ogdensburg, NY 13669-1142
Phone (315) 393-3600

739 Irving Ave
Suite 450
Syracuse, NY 13210-1663
Phone (315) 470-7364

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Prostate resection1-10
Upper gastrointestinal (GI) endoscopy for acid reflux28
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Claxton Medical PC CurrentSince Dec 7, 2019 Accepting new patients
Crouse Health Hospital, Inc. CurrentSince Apr 12, 2012 Accepting new patients
Physician Care PC Surgery CurrentSince Oct 1, 2017 Accepting new patients
Claxton Medical PC CurrentSince Dec 7, 2019 Accepting new patients
Crouse Medical Practice PLLC CurrentSince Jan 1, 2020 Accepting new patients
Pathology Associates of Syracuse, PC Current Accepting new patients
Crouse Health Hospital Inc Surgery CurrentSince Apr 12, 2012 Accepting new patients
Claxton-Hepburn Medical Center CurrentSince Oct 7, 2019 Accepting new patients
Crouse Medical Practice, PLLC CurrentSince Jan 1, 2020 Accepting new patients
Oswego Hospital Past Accepting new patients

Locations

39 W Main St
Canton, NY 13617
Phone (315) 379-4700

214 King St
Ogdensburg, NY 13669
Phone (315) 713-5660

3 Lyon Pl
Ogdensburg, NY 13669
Phone (315) 394-7542

3 Lyon Pl
Ste 302
Ogdensburg, NY 13669
Phone (315) 393-7955

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

140 W 6th St
Ste 280
Oswego, NY 13126
Phone (315) 207-0002

140 W 6th St
Ste LL30
Oswego, NY 13126
Phone (315) 349-5511

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

475 Irving Ave
Ste 500
Syracuse, NY 13210
Phone (315) 470-7291

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

739 Irving Ave
Ste 1
Syracuse, NY 13210

739 Irving Ave
Ste 450
Syracuse, NY 13210
Phone (315) 470-7364

Interoperability endpoints

  • Direct secure messaging: jdesimone@cahclinics.medentdirect.com
  • Direct secure messaging: jdesimone@crousemed.medentdirect.com
  • Direct secure messaging: jdesimone@hiemail.healtheconnections.org
  • Direct secure messaging: jeffrey.desimone@claxton.eclinicaldirectplus.com

Organizations & group practices 10

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 2

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1699726737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042866",
            "telephone_number": "315-937-3433",
            "fax_number": "315-470-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE",
            "address_2": "SUITE 450",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101651",
            "telephone_number": "315-470-7364",
            "fax_number": "315-470-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SIMONE",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "172879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01482200",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffreydesimone@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Syracuse",
            "address_1": "739 Irving Ave",
            "address_2": "Suite 450",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.