Individual provider Active NPI

David R Simon, MD

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1922089135
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G57931 Issued in CA
Practice address
100 S Anaheim Blvd Ste 101
Anaheim, CA 92805-3848
Phone
(714) 826-1200
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G57931 CA Primary

Addresses

Primary practice location

100 S Anaheim Blvd Ste 101
Anaheim, CA 92805-3848

Mailing address

100 S Anaheim Blvd Ste 101
Anaheim, CA 92805-3848
Phone (714) 826-1200

Other identifiers 1

IdentifierTypeStateIssuer
00G579310MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040526000778 CA Practitioner - Internal MedicinePractitioner - Emergency Medicine 1052392073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Geffen School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

100 S Anaheim Blvd
Suite 101
Anaheim, CA 92805-3848
Phone (714) 826-1200

11420 Warner Ave
Fountain Valley, CA 92708-2529
Phone (714) 549-1300

15464 Goldenwest St
Westminster, CA 92683-6149
Phone (714) 891-9008

18111 Brookhurst St
Suite 6100
Fountain Valley, CA 92708-6728
Phone (714) 378-7330

2110 N Bellflower Blvd
Long Beach, CA 90815-3126
Phone (562) 346-2222

23512 Madero
Mission Viejo, CA 92691-2743
Phone (949) 583-1600

4447 Candlewood St
Lakewood, CA 90712-1736
Phone (657) 241-9935

722 Baker St
Costa Mesa, CA 92626-4320
Phone (714) 557-6300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G57931CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Internal Medicine CurrentSince Feb 1, 2011 Accepting new patients
Pediatric Surgical Associates Inc a Medical Corporation Past Accepting new patients
Anaheim Memorial Hospital Emergency Physicians Medical Group Past Accepting new patients

Locations

100 S Anaheim Blvd
Ste 101
Anaheim, CA 92805
Phone (714) 826-1200

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

11420 Warner Ave
Fountain Vly, CA 92708
Phone (714) 549-1300

2742 Dow Ave
Tustin, CA 92780
Phone (714) 665-1600

Interoperability endpoints

  • Direct secure messaging: dsimon74830@direct.memorialcare.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.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1922089135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S ANAHEIM BLVD STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053848",
            "telephone_number": "714-826-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S ANAHEIM BLVD STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053848",
            "telephone_number": "714-826-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G57931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G579310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.