Individual provider Active NPI

Egbert Simon, MD

  • Internal Medicine Physician
  • Holmdel, NJ
National Provider Identifier
1699864439
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MAO6537200 Issued in NJ
Practice address
727 N Beers St
Bayshore Community Hospital
Holmdel, NJ 07733-1514
Phone
(732) 739-5900
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MAO6537200 NJ Primary

Addresses

Primary practice location

727 N Beers St
Bayshore Community Hospital
Holmdel, NJ 07733-1514

Mailing address

PO Box 748
Livingston, NJ 07039-0748

Other identifiers 1

IdentifierTypeStateIssuer
7344201MedicaidNJ

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
I20040218001009 NJ Practitioner - Internal Medicine 8921993858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Garden State Healthcare Associates LLCGroup PAC ID 8426190687, 171 clinicians

Practice addresses (Care Compare)

29 E 29TH St
Bayonne, NJ 07002-4654

308 Willow Ave
Hoboken, NJ 07030-3808

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07672300NJMDInternal Medicine Physician
25MAO6537200NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Garden State Healthcare Associates, LLC CurrentSince Mar 7, 2016 Accepting new patients
Hudson Hospital Opco LLC Current Accepting new patients
Humc Opco LLC Past Accepting new patients
Hospital Medicine Associates of Monmouth County, LLC Internal Medicine Past Accepting new patients
Ipc Hospitalist Physicians of New Jersey PC Internal Medicine Past Accepting new patients
Barnert FCC Housemeds Group Past Accepting new patients

Locations

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

Interoperability endpoints

  • Direct secure messaging: egbert.simon@direct.christhospital.md

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1699864439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070390748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N BEERS ST",
            "address_2": "BAYSHORE COMMUNITY HOSPITAL",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331514",
            "telephone_number": "732-739-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "EGBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MAO6537200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7344201",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.