Individual provider Active NPI

Beth Jennifer Simon, MD

  • Obstetrics & Gynecology Physician
  • Harrison, NY
National Provider Identifier
1972504132
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
215911-1 Issued in NY
Practice address
600 Mamaroneck Ave
Harrison, NY 10528-1635
Phone
(914) 723-8100
Fax
(914) 219-1928
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 215911-1 NY Primary

Addresses

Primary practice location

600 Mamaroneck Ave
Harrison, NY 10528-1635

Mailing address

500 W Putnam Ave
Greenwich, CT 06830-6086
Phone (475) 240-8222

Other practice location 1

259 Heathcote Rd
Scarsdale, NY 10583-4523
Phone (914) 723-8100 ext. 106

Other practice location 2

500 W Putnam Ave
Greenwich, CT 06830-6086
Phone (475) 240-8222

Other identifiers 1

IdentifierTypeStateIssuer
02317839MedicaidNY

Other names 1

  • Beth Jennifer Roth Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120222000387 NY Practitioner - Obstetrics/Gynecology 6901064997
I20191203002751 CT Practitioner - Obstetrics/Gynecology 6901064997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Albert Einstein College of Medicine of Yeshiva University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

500 W Putnam Ave
Greenwich, CT 06830-6086
Phone (203) 863-3671

Hospital & facility affiliations

  • Greenwich Hospital Association - Hospital, Greenwich, CT, CCN 070018
  • White Plains Hospital Center Hospital, White Plains, NY, CCN 330304

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
215911-1NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Obstetrics & Gynecology CurrentSince Dec 30, 2019 Accepting new patients
St Lukes Roosevelt Community Care Obstetrics & Gynecology Past Accepting new patients
Northeast Medical Group, PLLC Obstetrics & Gynecology Past Accepting new patients
St Lukes Roosevelt Hospital Center Obstetrics & Gynecology Past Accepting new patients

Locations

500 W Putnam Ave
Ste 7B
Greenwich, CT 06830

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

500 W Putnam Ave
Greenwich, CT 06830
Phone (203) 869-2510

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: bsimon160510@direct.ynhh.org

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.

Hospital & facility affiliations 2

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1972504132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W PUTNAM AVE",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306086",
            "telephone_number": "475-240-8222",
            "fax_number": "475-240-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MAMARONECK AVE",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105281635",
            "telephone_number": "914-723-8100",
            "fax_number": "914-219-1928"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "259 Heathcote Rd",
            "address_purpose": "LOCATION",
            "city": "Scarsdale",
            "state": "NY",
            "postal_code": "105834523",
            "country_code": "US",
            "telephone_number": "914-723-8100 x106",
            "fax_number": "914-219-1928",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 W Putnam Ave",
            "address_purpose": "LOCATION",
            "city": "Greenwich",
            "state": "CT",
            "postal_code": "068306086",
            "country_code": "US",
            "telephone_number": "475-240-8222",
            "fax_number": "475-240-8223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "BETH",
        "middle_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "215911-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02317839",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "ROTH",
            "middle_name": "JENNIFER",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harrison, NY

Sources for this page

Verify at the official NPI Registry.