Individual provider Active NPI

Marc Harold Simonson, MD

  • Diagnostic Radiology Physician
  • Union City, NJ
National Provider Identifier
1902973589
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MA043043 Issued in NJ
Practice address
415 43Rd Street
Union City, NJ 07087
Phone
(201) 867-9002
Fax
(201) 867-2004
NPI assigned
Nov 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MA043043 NJ Primary

Addresses

Primary practice location

415 43Rd Street
Union City, NJ 07087

Mailing address

PO Box 4456
Union City, NJ 07087
Phone (201) 867-9002

Other identifiers 1

IdentifierTypeStateIssuer
1568205MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050801001023 NJ Practitioner - Diagnostic Radiology 7012945959 Practice locations: Jersey City, NJ; Newark, NJ; Union City, NJ; West Orange, NJ

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

129 Newark Ave
Jersey City, NJ 07302-2811
Phone (201) 860-9500

415 43Rd St
Union City, NJ 07087-5009
Phone (201) 867-9002

77 Main St
Suite 1
West Orange, NJ 07052-5418
Phone (973) 669-1727

P O Box
Suite 4456
Union City, NJ 07087-5009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA043043NJMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fenny Pharmacy LLC Past Accepting new patients
Bipin J Parikh Mdpa Past Accepting new patients

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, 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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902973589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4456",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "07087",
            "telephone_number": "201-867-9002",
            "fax_number": "201-867-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 43RD STREET",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "07087",
            "telephone_number": "201-867-9002",
            "fax_number": "201-867-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSON",
        "first_name": "MARC",
        "middle_name": "HAROLD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "MA043043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568205",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

Verify at the official NPI Registry.