Active NPI
Ashley Kittles Simonak, D.O.
- Diagnostic Radiology Physician
- Charleston, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 1274
- Practice address
- 171 Ashley Ave
Charleston, SC 29425-8908 - Phone
- (843) 792-1414
- NPI assigned
- Jun 26, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | LL1274 | SC | |
| Diagnostic Radiology Physician | 2085R0202X | 1274 | SC | Primary |
Addresses
Primary practice location
171 Ashley Ave
Charleston, SC 29425-8908
Mailing address
PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LL1274 | Other | SC | LIMITED LICENSE NUMBER |
Other names 1
- Ashley Marie Kittles
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of North Texas HSC, College of Osteopathic Med, 2009
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
815 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone (817) 321-0470
Hospital & facility affiliations
- Baylor Scott & White Medical Center at Irving
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL1274 | SC | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Stone JV LLP | Current | Accepting new patients | |
| Radiology Associates of North Texas PA | Diagnostic Radiology | Current | Accepting new patients |
| Clinical Care in Radiology | Current | Accepting new patients | |
| Radiology Associates of North Texas PA | Diagnostic Radiology | Current | Accepting new patients |
Locations
17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303
815 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 321-0300
816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312
1901 N MacArthur Blvd
Irving, TX 75061
Phone (972) 484-5192
2120 N MacArthur Blvd
Ste 100
Irving, TX 75061
Phone (972) 438-4636
Organizations & group practices 4
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.
-
- Diagnostic Radiology Physician
- Fort Worth, TX
- NPI 1710970975
-
- Physiological Laboratory
- Flower Mound, TX
- NPI 1336500297
-
- Physician Assistant
- Fort Worth, TX
- NPI 1578331393
-
- Diagnostic Radiology Physician
- Fort Worth, TX
- NPI 1730467440
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Irving, TX
- NPI 1114268471
-
- General Acute Care Hospital
- Irving, TX
- NPI 1992700983
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403481600000",
"number": "1932337037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751461",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751461",
"telephone_number": "843-792-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 ASHLEY AVE",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258908",
"telephone_number": "843-792-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONAK",
"first_name": "ASHLEY",
"middle_name": "KITTLES",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-26",
"last_updated": "2014-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "SC",
"license": "LL1274",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "SC",
"license": "1274",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIMITED LICENSE NUMBER",
"identifier": "LL1274",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ASHLEY",
"last_name": "KITTLES",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.