Individual provider Active NPI

Simi Simon, O.D.

  • Optometrist
  • Sugar Land, TX
National Provider Identifier
1700136603
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8373TG Issued in TX
Practice address
18851 University Blvd Ste 220
Sugar Land, TX 77479-6818
Phone
(713) 714-2320
NPI assigned
Sep 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3281-35 WI
Optometrist 152W00000X 8373TG TX Primary

Addresses

Primary practice location

18851 University Blvd Ste 220
Sugar Land, TX 77479-6818

Mailing address

18851 University Blvd Ste 220
Sugar Land, TX 77479-6818

Other practice location 1

4301 W Wisconsin Ave
Appleton, WI 54913-8605
Phone (920) 730-8770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200813001389 TX Practitioner - Optometry 7911323530 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

4725 Hwy 6
Missouri City, TX 77459-3988
Phone (832) 403-3921

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8373TXMDBehavioral Analyst
8373TGTXMDOptometrist
3281-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Underwood Eye Associates, PLLC Optometrist CurrentSince Apr 3, 2022 Accepting new patients
Tso Richmond Aliana PA Optometrist CurrentSince Jul 1, 2020 Accepting new patients
Tso Kingwood North Park PA Optometrist CurrentSince Jul 1, 2020 Accepting new patients
Tso Rayford PA Optometrist CurrentSince Jul 1, 2020 Accepting new patients

Locations

25639 Highway 59 N
Ste 109
Kingwood, TX 77339
Phone (832) 810-2020

10117 W Grand Pkwy S
Ste 101
Richmond, TX 77407
Phone (832) 781-2020

10117 W Grand Pkwy S
Ste 101
Richmond, TX 77407
Phone (832) 781-2020

3535 Rayford Rd
Ste 500
Spring, TX 77386
Phone (832) 791-2020

18851 University Blvd
Ste 220
Sugar Land, TX 77479
Phone (713) 714-2320

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1700136603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18851 UNIVERSITY BLVD STE 220",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774796818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18851 UNIVERSITY BLVD STE 220",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774796818",
            "telephone_number": "713-714-2320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549138605",
            "country_code": "US",
            "telephone_number": "920-730-8770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "SIMI",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3281-35",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8373TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.