Individual provider Active NPI

Rachel Nicole Simoes, PA-C

  • Surgical Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1770155517
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9118514 Issued in FL
Practice address
625 6TH Ave S
St Petersburg, FL 33701-4662
Phone
(727) 893-6363
Fax
(727) 893-6364
NPI assigned
Jul 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.006994RX OH
Surgical Physician Assistant 363AS0400X PA9118514 FL Primary

Addresses

Primary practice location

625 6TH Ave S
St Petersburg, FL 33701-4662

Mailing address

625 6TH Ave S
St Petersburg, FL 33701-4662
Phone (727) 893-6363

Other practice location 1

6780 Mayfield Rd
Mayfield Heights, OH 44124-2294
Phone (440) 312-4500

Other identifiers 1

IdentifierTypeStateIssuer
124184100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20241008000041 FL Practitioner - Physician Assistant 2264838572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

603 7TH St S
St Petersburg, FL 33701-4719

701 6TH St S
St Petersburg, FL 33701-4814
Phone (727) 823-1234

Hospital & facility affiliations

  • Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group, LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1770155517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 6TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014662",
            "telephone_number": "727-893-6363",
            "fax_number": "727-893-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 6TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014662",
            "telephone_number": "727-893-6363",
            "fax_number": "727-893-6364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6780 Mayfield Rd",
            "address_purpose": "LOCATION",
            "city": "Mayfield Heights",
            "state": "OH",
            "postal_code": "441242294",
            "country_code": "US",
            "telephone_number": "440-312-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMOES",
        "first_name": "RACHEL",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006994RX",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9118514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124184100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.