Eboni Simmons, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SP018188 Issued in PA

Practice address

5501 Old York Rd # 4320
Philadelphia, PA 19141-3018

Phone

(215) 456-3901

NPI assigned

May 11, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Keystonecare Home Health, LLC Home health agency, Wyndmoor, PA, CCN 398100
• Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Einstein Practice Plan Inc

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1760434468
  Medicare reassignment Care Compare group NPD
• Einstein Practice Plan Inc

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
  • NPI 1457047433
  NPD
• Einstein Practice Plan Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Philadelphia, PA
  • NPI 1609827757
  NPD
• Einstein Practice Plan Inc

  • Surgery Physician
  • Philadelphia, PA
  • NPI 1992761621
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Einstein Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1366653818
  Care Compare affiliation Name & address match
• Keystonecare Home Health LLC

  • Home Health Agency
  • Wyndmoor, PA
  • NPI 1861630030
  Care Compare affiliation

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1770073090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD # 4320",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD # 4320",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "EBONI",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP018188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry Brent Simmons Jr., M.D.
• Burnell Marcus Simmons Jr.
• Christina N Simmons
• Christine Marie Simmons
• Courtney Simmons
• Erik J Simmons
• George Simmons III
• Hanesha Simmons, RN
• Jennifer C. Simmons, M.D.
• John Preston Simmons, MD

• Gerontology Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.

Verify at the official NPI Registry.