Individual provider Active NPI

John Felix Simora, D.O.

  • Psychiatry Physician
  • Bradford, PA
National Provider Identifier
1770776049
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OS013798 Issued in PA
Practice address
800 E Main St
Bradford, PA 16701-3278
Phone
(814) 817-1400
NPI assigned
Aug 21, 2007
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OS013798 PA Primary

Addresses

Primary practice location

800 E Main St
Bradford, PA 16701-3278

Mailing address

PO Box 192
Stow, NY 14785-0192
Phone (814) 366-1385

Other identifiers 1

IdentifierTypeStateIssuer
102464950MedicaidPA

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
I20101230000185 PA Practitioner - Psychiatry 0345438669 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Olean General Hospital CurrentSince Jan 12, 2018 Accepting new patients
Deerfield Behavioral Health of Warren, LLC Psychiatry CurrentSince Oct 18, 2022 Accepting new patients
Children's Center for Treatment and Education Current Accepting new patients
Childrens Center for Treatment and Education CurrentSince Aug 3, 2010 Accepting new patients
Olean General Hospital CurrentSince Jan 12, 2018 Accepting new patients
Ramsbottom Center, Inc. Past Accepting new patients

Locations

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

116 Interstate Pkwy
Bradford, PA 16701
Phone (814) 362-8674

200 Pleasant St
Bradford, PA 16701
Phone (814) 362-8293

23 Kennedy St
Bradford, PA 16701
Phone (814) 723-1832

47 Beacon Light Way
Bradford, PA 16701

406 Franklin St
Smethport, PA 16749
Phone (814) 887-5655

1003 Pennsylvania Ave W
Warren, PA 16365
Phone (814) 723-5545

1885 Market St
Warren, PA 16365
Phone (716) 664-8510

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1770776049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192",
            "city": "STOW",
            "state": "NY",
            "postal_code": "147850192",
            "telephone_number": "814-366-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E MAIN ST",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167013278",
            "telephone_number": "814-817-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMORA",
        "first_name": "JOHN",
        "middle_name": "FELIX",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS013798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102464950",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, PA

Sources for this page

Verify at the official NPI Registry.