Iouri Ivanovich Simonenko, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A147937 Issued in CA

Practice address

525 E Main St
El Cajon, CA 92020-4007

Phone

(619) 515-2300

Fax

(619) 269-0674

NPI assigned

Jun 19, 2008

Last updated

Feb 8, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Psychiatry

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

LGTC GroupGroup PAC ID 0749795102, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• LGTC Group

  • Marriage & Family Therapist
  • San Jose, CA
  • NPI 1881482941

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Los Gatos Therapy Center

  dba LGTC Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1518600972
  NPD (past)
• WK Medical Group

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1588083992
  NPD (past)
• Compass Health, Inc

  dba Compass Health Network

  • Community/Behavioral Health Agency
  • Clinton, MO
  • NPI 1285619494
  NPD (past)

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1891956157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300",
            "fax_number": "619-269-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E MAIN ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920204007",
            "telephone_number": "619-515-2300",
            "fax_number": "619-269-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONENKO",
        "first_name": "IOURI",
        "middle_name": "IVANOVICH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A147937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alphonso Lamarr Simmons
• Ebonee Alyssa Simmons, MFT
• Ashley Mark Simon
• Ghiezelle Lynn Simon
• Mario Marcos Simon
• Christopher T Simonet, PH.D.
• Melanie Jewel Simpkins
• Dale Gilman Simpson, MSW, LCSW
• Gianna Rose Sinex
• Angela Maria Singer

• Psychiatry Physician in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.