Individual provider Active NPI

Matthew Leonard Simon, M.D.

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1790927101
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P2166 Issued in TX
Practice address
8215 Westchester Dr Ste 150
Dallas, TX 75225-6126
Phone
(214) 361-7185
Fax
(214) 373-4841
NPI assigned
Mar 31, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P2166 TX Primary

Addresses

Primary practice location

8215 Westchester Dr Ste 150
Dallas, TX 75225-6126

Mailing address

8215 Westchester Dr Ste 150
Dallas, TX 75225-6126
Phone (214) 361-7185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140806001918 TX Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4789801275

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P2166TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Cities Pediatrics Pediatrics PastSince Apr 17, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: msimon31751@direct.childrens.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1790927101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8215 WESTCHESTER DR STE 150",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752256126",
            "telephone_number": "214-361-7185",
            "fax_number": "214-373-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8215 WESTCHESTER DR STE 150",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752256126",
            "telephone_number": "214-361-7185",
            "fax_number": "214-373-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "MATTHEW",
        "middle_name": "LEONARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-31",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P2166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.