Individual provider Active NPI

David Simon, DO

  • Family Medicine Physician
  • Lake Worth, FL
National Provider Identifier
1912979279
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS4930 Issued in FL
Practice address
101 S Federal Hwy
Lake Worth, FL 33460
Phone
(561) 582-4151
Fax
(561) 582-4393
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
Yes

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
Family Medicine Physician 207Q00000X OS4930 FL Primary

Addresses

Primary practice location

101 S Federal Hwy
Lake Worth, FL 33460

Mailing address

101 S Federal Hwy
Lake Worth, FL 33460
Phone (561) 582-4151

Other identifiers 1

IdentifierTypeStateIssuer
82727OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20101013000753 FL Practitioner - Family Practice 2365634045 Practice locations: Lake Worth, FL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 S Federal Hwy
Lake Worth, FL 33460-4228
Phone (561) 582-4151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS4930FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palms West Imaging Inc Past Accepting new patients
Palms West MRI, LLC Past Accepting new patients
Nova Cat Incorporation Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: david.simon@653.emedpractice.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912979279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S FEDERAL HWY",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33460",
            "telephone_number": "561-582-4151",
            "fax_number": "561-582-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S FEDERAL HWY",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33460",
            "telephone_number": "561-582-4151",
            "fax_number": "561-582-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS4930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82727",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.