Active NPI
Simon Shimon Lipetz, M.D.
- Internal Medicine Physician
- Forest Hills, NY
National Provider Identifier
1710967393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 186190
- Practice address
- 10460 Queens Blvd
Forest Hills, NY 11375-7301 - Phone
- (718) 275-4849
- Fax
- (718) 275-6381
- NPI assigned
- Jan 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 186190 | NY | Primary |
Addresses
Primary practice location
10460 Queens Blvd
Forest Hills, NY 11375-7301
Mailing address
74 Hayloft LN
Roslyn Heights, NY 11577-2634
Phone (616) 484-1117
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2501904 | Other | NY | GHI |
| QN0059001 | Other | NY | AMERICHOICE |
| 3C0053 | Other | NY | HEALTHNET |
| DP443 | Other | NY | OXFORD INSURANCE CO. |
| 53K521 | Other | NY | BLUE CROSS/BLUE SHIELD |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
104 -60 Queens Blvd
Suite CH
Forest Hills, NY 11375-7318
10460 Queens Blvd
Suite CH
Forest Hills, NY 11375-7366
Phone (718) 275-4849
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 28.04 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 93.45
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simon Lipetz MD. P.C | Internal Medicine | Current | Accepting new patients |
Locations
10460 Queens Blvd
Ste Ch
Forest Hills, NY 11375
Phone (212) 663-3600
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 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Brooklyn, NY
- NPI 1770513145
-
- Rehabilitation Hospital Unit
- New York, NY
- NPI 1275632895
-
dba NYU Langone Hospital Long Island
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
-
- General Acute Care Hospital
- New York, NY
- NPI 1669578324
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516838400000",
"number": "1710967393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 HAYLOFT LN",
"city": "ROSLYN HEIGHTS",
"state": "NY",
"postal_code": "115772634",
"telephone_number": "616-484-1117",
"fax_number": "516-484-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10460 QUEENS BLVD",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113757301",
"telephone_number": "718-275-4849",
"fax_number": "718-275-6381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPETZ",
"first_name": "SIMON",
"middle_name": "SHIMON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2018-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "186190",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "2501904",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICHOICE",
"identifier": "QN0059001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "3C0053",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD INSURANCE CO.",
"identifier": "DP443",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "53K521",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.