Shiju M Simon, AA-C

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

9220 Issued in GA

Practice address

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694

Phone

(678) 312-1000

NPI assigned

Aug 26, 2015

Last updated

Mar 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  Medicare reassignment Care Compare group NPD
• American Anesthesiology Associates of Georgia, LLC

  • Anesthesiology Physician
  • Stone Mountain, GA
  • NPI 1528068673
  Medicare reassignment NPD
• Coastal Ambulatory Anesthesia LLC

  • Anesthesiology Physician
  • Savannah, GA
  • NPI 1750753786
  Medicare reassignment NPD
• Gi Anesthesia of Georgia LLC

  • Certified Registered Nurse Anesthetist
  • Gainesville, GA
  • NPI 1326569187
  Medicare reassignment NPD
• North Atlanta Professional Services LLC

  • Psychologist
  • Atlanta, GA
  • NPI 1316959869
  Medicare reassignment NPD
• S & J PA

  • Anesthesiology Physician
  • New Port Richey, FL
  • NPI 1568910628
  NPD (past)

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

• Dekalb Medical Center, Inc.

  dba Emory Decatur Hospital

  • General Acute Care Hospital
  • Decatur, GA
  • NPI 1093716979
  Care Compare affiliation

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1942677919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 GRASSMEADE WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300787782",
            "telephone_number": "404-271-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467694",
            "telephone_number": "678-312-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9330 State Road 54",
            "address_2": "Medical Center Trinity",
            "address_purpose": "LOCATION",
            "city": "Trinity",
            "state": "FL",
            "postal_code": "346551808",
            "country_code": "US",
            "telephone_number": "727-848-1733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "SHIJU",
        "middle_name": "M",
        "credential": "AA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-26",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA287",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "9220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015893200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chloe Simmons
• Stacey Lizette Simmons
• Stacey Michelle Simmons, OT
• Justin Simon, M.A., LAPC, NCC, CP
• Saleeb Simon, LCSW
• Simple Faith Wellness LLC
• Cynthia Denise Simpson
• Bryanna Sims
• Ladawn Sims, RN
• Marcus Ceri Sims, M.D.

• Anesthesiologist Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Anesthesiologist Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.