Individual provider Active NPI

Simon Ermakov, M.D.

  • Cardiovascular Disease Physician
  • Mountain View, CA
National Provider Identifier
1811331747
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A134064 Issued in CA
Practice address
701 E El Camino Real
Mountain View, CA 94040-2833
Phone
(650) 404-8300
NPI assigned
Apr 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A134064 CA Primary

Addresses

Primary practice location

701 E El Camino Real
Mountain View, CA 94040-2833

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210128002364 CA Practitioner - Cardiovascular Disease (Cardiology) 6800189622 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of California, San Francisco School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

701 E El Camino Real
Mountain View, CA 94040-2833
Phone (650) 691-6174

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134064CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Apr 4, 2022 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 4, 2022 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 4, 2022 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 4, 2022 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 4, 2022 Accepting new patients
Sutter East Bay Medical Foundation Cardiovascular Disease Past Accepting new patients
El Camino Hospital Past Accepting new patients

Locations

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

715 Altos Oaks Dr
Los Altos, CA 94024
Phone (650) 934-7010

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

701 E El Camino Real
#1
Mountain View, CA 94040
Phone (650) 404-8440

701 E El Camino Real
Mountain View, CA 94040
Phone (650) 404-8370

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

2581 Samaritan Dr
Ste 308
San Jose, CA 95124
Phone (408) 355-1700

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

300 Pasteur Dr
#154
Stanford, CA 94305

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: sermakov405662@hisp.ehr.sutterhealth.org

Organizations & group practices 7

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 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": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1811331747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E EL CAMINO REAL",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402833",
            "telephone_number": "650-404-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERMAKOV",
        "first_name": "SIMON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A134064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lawrence Express Way",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.