Individual provider Active NPI

Lisa A Simmon, M.D.

  • Hospitalist Physician
  • Glendale, AZ
National Provider Identifier
1922430008
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
50672 Issued in AZ
Practice address
5555 W. Thunderbird
Banner Thunderbird Medical Center
Glendale, AZ 85306
Phone
(602) 865-2627
Fax
(602) 865-2632
NPI assigned
Jul 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 50672 AZ Primary
Internal Medicine Physician 207R00000X 50672 AZ

Addresses

Primary practice location

5555 W. Thunderbird
Banner Thunderbird Medical Center
Glendale, AZ 85306

Mailing address

5555 W. Thunderbird
Banner Thunderbird Medical Center
Glendale, AZ 85306
Phone (602) 865-2627

Other names 1

  • Lisa A Rauls Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150922002261 AZ Practitioner - Family Practice 9638395767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Hospital Based Physicians Arizona LLCGroup PAC ID 3274782487, 636 clinicians

Practice addresses (Care Compare)

5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone (602) 865-5555

Hospital & facility affiliations

  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089

Merit-based Incentive Payment System (MIPS)

Final score
83.7 of 100Reported as group
Quality
64.97
Promoting interoperability
98
Improvement activities
40
Cost
69.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50672AZMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Aug 1, 2015 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Aug 1, 2015 Accepting new patients

Locations

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1922430008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 W. THUNDERBIRD",
            "address_2": "BANNER THUNDERBIRD MEDICAL CENTER",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85306",
            "telephone_number": "602-865-2627",
            "fax_number": "602-865-2632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W. THUNDERBIRD",
            "address_2": "BANNER THUNDERBIRD MEDICAL CENTER",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85306",
            "telephone_number": "602-865-2627",
            "fax_number": "602-865-2632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMON",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "50672",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "50672",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "RAULS",
            "middle_name": "A",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.