Individual provider Active NPI

Kerri A Simo, MD

  • Surgery Physician
  • Toledo, OH
National Provider Identifier
1700096088
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35121983 Issued in OH
Practice address
2121 Hughes Dr
Suite 710
Toledo, OH 43606-3845
Phone
(419) 291-2671
Fax
(419) 291-2680
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2007-00092 NC
Surgery Physician 208600000X 35121983 OH Primary

Addresses

Primary practice location

2121 Hughes Dr
Suite 710
Toledo, OH 43606-3845

Mailing address

2121 Hughes Dr
Suite 710
Toledo, OH 43606-3845
Phone (419) 291-2671

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksimo13027@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130918000536 OH Practitioner - General Surgery 8628163755 Reassigns benefits to 1 organization
I20170316001360 MI Practitioner - General Surgery 8628163755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

2901 N Reynolds Rd
Toledo, OH 43606
Phone (419) 578-7700

5200 Harroun Rd
Sylvania, OH 43560-2168
Phone (419) 824-1444

777 Kimole LN
Suite 250
Adrian, MI 49221-1400
Phone (888) 593-5815

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007-00092NCMDSurgery Physician
35121983OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Surgery CurrentSince Aug 19, 2013 Accepting new patients
Promedica Central Physicians CurrentSince Aug 19, 2013 Accepting new patients
The Toledo Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

777 Kimole Ln
Ste 250
Adrian, MI 49221
Phone (517) 265-3411

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2121 Hughes Dr
Ste 710
Toledo, OH 43606
Phone (419) 291-2610

1 Seagate
#800
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2109 Hughes Dr
Ste 760
Toledo, OH 43606
Phone (419) 291-7555

Organizations & group practices 4

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 5

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1700096088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 HUGHES DR",
            "address_2": "SUITE 710",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063845",
            "telephone_number": "419-291-2671",
            "fax_number": "419-291-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 HUGHES DR",
            "address_2": "SUITE 710",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063845",
            "telephone_number": "419-291-2671",
            "fax_number": "419-291-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMO",
        "first_name": "KERRI",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2007-00092",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35121983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksimo13027@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.