Individual provider Active NPI

Elisabeth Simon, M.D.

  • Pediatric Nephrology Physician
  • Albany, NY
National Provider Identifier
1952397192
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
193691 Issued in NY
Practice address
47 New Scotland Ave
Albany, NY 12208-3412
Phone
(518) 262-9440
Fax
(518) 262-9443
NPI assigned
Sep 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 193691 NY Primary

Addresses

Primary practice location

47 New Scotland Ave
Albany, NY 12208-3412

Mailing address

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-9440

Other identifiers 1

IdentifierTypeStateIssuer
00146478MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20041207000962 NY Practitioner - Pediatric MedicinePractitioner - Nephrology 0345206710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

22 New Scotland Ave
Albany, NY 12208-3795
Phone (518) 262-5723

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
193691NYMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Jan 2, 2003 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients
Albany Medical College Pediatric Nephrology CurrentSince Jan 2, 2003 Accepting new patients

Locations

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

22 New Scotland Ave
Albany, NY 12208
Phone (518) 262-5333

47 New Scotland Ave
#139
Albany, NY 12208
Phone (518) 262-3773

1275 Broadway
Menands, NY 12204
Phone (518) 262-9705

Interoperability endpoints

  • Direct secure messaging: esimon29586@albanymed.direct-ci.com

Organizations & group practices 5

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1952397192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-9440",
            "fax_number": "518-262-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-9440",
            "fax_number": "518-262-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "ELISABETH",
        "name_prefix": "Prof.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NY",
            "license": "193691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00146478",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.