Individual provider Active NPI

Lawrence F. Simon, M.D.

  • Surgery Physician
  • West Nyack, NY
National Provider Identifier
1710045281
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
096815-1 Issued in NY
Practice address
1Crosfield Ave
Suite 105
West Nyack, NY 10994
Phone
(845) 535-3362
Fax
(845) 535-3368
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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 096815-1 NY Primary

Addresses

Primary practice location

1Crosfield Ave
Suite 105
West Nyack, NY 10994

Mailing address

1 Crosfield Ave
Suite 105
West Nyack, NY 10994-2222
Phone (845) 535-3362

Other identifiers 1

IdentifierTypeStateIssuer
00496373MedicaidNY

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
I20100810000536 NY Practitioner - General Surgery 9537293758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State University of Ny Upstate Medical University, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White Plains Medical Diagnostic Services, PCGroup PAC ID 5395918932, 95 clinicians

Practice addresses (Care Compare)

160 N Midland Ave
Nyack, NY 10960-1912
Phone (845) 480-7440

41 E Post Rd
White Plains, NY 10601-4607
Phone (914) 681-1201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
096815-1NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White Plains Medical Diagnostic Services, PC Surgery CurrentSince Oct 1, 2022 Accepting new patients

Locations

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

97 Route 303
Tappan, NY 10983
Phone (845) 348-2198

1 Crosfield Ave
Ste 105
West Nyack, NY 10994
Phone (845) 535-3362

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1710045281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CROSFIELD AVE",
            "address_2": "SUITE 105",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942222",
            "telephone_number": "845-535-3362",
            "fax_number": "845-535-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1CROSFIELD AVE",
            "address_2": "SUITE 105",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "10994",
            "telephone_number": "845-535-3362",
            "fax_number": "845-535-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "LAWRENCE",
        "middle_name": "F.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "096815-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00496373",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Nyack, NY

Sources for this page

Verify at the official NPI Registry.