Active NPI
Gloria Susan Simon
- Social Worker
- Kissimmee, FL
National Provider Identifier
1942487301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 00078986
- Practice address
- 3718 Paradiso Cir
Kissimmee, FL 34746-1950 - Phone
- (607) 759-3312
- Fax
- (973) 771-3180
- NPI assigned
- Jan 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904011199 | VA | |
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 44SC05509600 | NJ | |
| Social Worker | 104100000X | 00078986 | NY | Primary |
Addresses
Primary practice location
3718 Paradiso Cir
Kissimmee, FL 34746-1950
Mailing address
3718 Paradiso Cir
Kissimmee, FL 34746-1950
Phone (973) 771-8905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2025 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00078986 | NY | MD | Social Worker |
| 44SC05509600 | NJ | MD | Clinical Social Worker |
| 0904011199 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gregory Heifler, MD, PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Montclair, NJ
- NPI 1437357944
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1942487301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3718 PARADISO CIR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347461950",
"telephone_number": "973-771-8905",
"fax_number": "973-771-3180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3718 PARADISO CIR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347461950",
"telephone_number": "607-759-3312",
"fax_number": "973-771-3180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "GLORIA",
"middle_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-29",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904011199",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC05509600",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "00078986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.