Individual provider Active NPI

Andrea Lynn Pickup-Simonin, MSN, FNP-C

  • Nurse Practitioner
  • North Dartmouth, MA
National Provider Identifier
1841720968
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN260456 Issued in MA
Practice address
500 Faunce Corner Rd
North Dartmouth, MA 02747-1278
Phone
(508) 973-2216
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN260456 MA
Nurse Practitioner 363L00000X RN260456 MA Primary

Addresses

Primary practice location

500 Faunce Corner Rd
North Dartmouth, MA 02747-1278

Mailing address

200 Mill Rd
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170921001248 MA Practitioner - Nurse Practitioner 7911271457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

500 Faunce Corner Rd
North Dartmouth, MA 02747-1278
Phone (508) 973-2216

Hospital & facility affiliations

  • Southcoast Visiting Nurse Association Inc Home health agency, Fairhaven, MA, CCN 227101
  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN260456MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. Current Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jan 18, 2023 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jan 18, 2023 Accepting new patients

Locations

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

387 Quarry St
Ste 100
Fall River, MA 02723
Phone (508) 679-8111

500 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 973-2216

500 Faunce Corner Rd
Ste 170
North Dartmouth, MA 02747
Phone (508) 973-2216

Interoperability endpoints

  • Direct secure messaging: asimonin17488@direct.southcoast.org

Organizations & group practices 3

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 2

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1841720968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FAUNCE CORNER RD",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027471278",
            "telephone_number": "508-973-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKUP-SIMONIN",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN260456",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN260456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Dartmouth, MA

Sources for this page

Verify at the official NPI Registry.