Individual provider Active NPI

Agnes H Simmons, M. D.

  • Adult Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1770650970
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
MD021009E Issued in PA
Practice address
6201 Chestnut St
Philadelphia, PA 19139-2906
Phone
(215) 747-1744
Fax
(215) 747-0336
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X MD021009E PA Primary

Addresses

Primary practice location

6201 Chestnut St
Philadelphia, PA 19139-2906

Mailing address

P. O. Box 13042
Philadelphia, PA 19101
Phone (215) 747-1744

Other identifiers 1

IdentifierTypeStateIssuer
000632366MedicaidPA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080806000666 PA Practitioner - General Practice 7719051929 Practice locations: Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6201 Chestnut St
Philadelphia, PA 19139-2906
Phone (215) 747-1744

Hospital & facility affiliations

  • Mercy Catholic Medical Center- Mercy Fitzgerald Hospital, Darby, PA, CCN 390156
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD021009EPAMDAdult Medicine Physician

Hospital & facility affiliations 3

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1770650970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 13042",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19101",
            "telephone_number": "215-747-1744",
            "fax_number": "215-747-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191392906",
            "telephone_number": "215-747-1744",
            "fax_number": "215-747-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "AGNES",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "PA",
            "license": "MD021009E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000632366",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.