Active NPI
Reese Sim
- Pediatric Critical Care Medicine Physician
- Philadelphia, PA
National Provider Identifier
1760001713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- MT230424
- Practice address
- 3401 Civic Center Blvd
Division of Pediatric Critical Care Medicine
Philadelphia, PA 19104 - Phone
- (800) 879-2467
- NPI assigned
- Apr 9, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | MT230424 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Division of Pediatric Critical Care Medicine
Philadelphia, PA 19104
Mailing address
3401 Civic Center Blvd
Division of Pediatric Critical Care Medicine
Philadelphia, PA 19104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT230424 | PA | MD | Pediatric Critical Care Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717372800000",
"number": "1760001713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF PEDIATRIC CRITICAL CARE MEDICINE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF PEDIATRIC CRITICAL CARE MEDICINE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "800-879-2467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIM",
"first_name": "REESE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-09",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "PA",
"license": "MT230424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.