Individual provider Active NPI

Ashley Simon

  • Family Nurse Practitioner
  • Jamaica, NY
National Provider Identifier
1881316438
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
350341 Issued in NY
Practice address
16814 Jamaica Ave
Jamaica, NY 11432-5216
Phone
(718) 650-5553
NPI assigned
Sep 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 350341 NY Primary

Addresses

Primary practice location

16814 Jamaica Ave
Jamaica, NY 11432-5216

Mailing address

16814 Jamaica Ave
Jamaica, NY 11432-5216
Phone (718) 650-5553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230615000177 NY Practitioner - Nurse Practitioner 4082072582 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
350341NYMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Medical Family Practice PC CurrentSince May 1, 2023 Accepting new patients
Ag Urgent Care, P.C. CurrentSince May 1, 2023 Accepting new patients

Locations

1295 Broadway
Brooklyn, NY 11221
Phone (718) 682-3903

9525 Church Ave
Brooklyn, NY 11212
Phone (718) 513-6178

4809 Avenue N
Brooklyn, NY 11234
Phone (718) 252-4120

16814 Jamaica Ave
Jamaica, NY 11432
Phone (718) 650-5553

Organizations & group practices 2

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": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1881316438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16814 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325216",
            "telephone_number": "718-650-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16814 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325216",
            "telephone_number": "718-650-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.