Individual provider Active NPI

Robert Simons, P.A.-C

  • Physician Assistant
  • San Luis Obispo, CA
National Provider Identifier
1841388071
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17586 Issued in CA
Practice address
35 Casa St
San Luis Obispo, CA 93405-1818
Phone
(805) 250-4844
Fax
(805) 785-0356
NPI assigned
Oct 11, 2006
Last updated
Dec 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17586 CA Primary

Addresses

Primary practice location

35 Casa St
San Luis Obispo, CA 93405-1818

Mailing address

35 Casa St
San Luis Obispo, CA 93405-1818
Phone (805) 250-4844

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090106000130 CA Practitioner - Physician Assistant 1658434485 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA17586CAMDPhysician Assistant
17586CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc CurrentSince May 24, 2014 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince May 24, 2014 Accepting new patients
First Choice Physician Partners CurrentSince Jan 3, 2017 Accepting new patients
Orange County Urgent Care #3, Inc. CurrentSince Aug 24, 2019 Accepting new patients
First Choice Physician Partners CurrentSince Jan 3, 2017 Accepting new patients
First Choice Physician Partners Past Accepting new patients

Locations

7330 El Camino Real
Atascadero, CA 93422
Phone (805) 703-2501

2415 E Imperial Hwy
Brea, CA 92821
Phone (714) 255-1640

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

35 Casa St
Ste 320
San Luis Obispo, CA 93405
Phone (805) 250-4844

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, 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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1841388071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CASA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051818",
            "telephone_number": "805-250-4844",
            "fax_number": "805-785-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CASA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051818",
            "telephone_number": "805-250-4844",
            "fax_number": "805-785-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.