Individual provider Active NPI

Robert Bradley Simon, MD

  • Urology Physician
  • Cliffside Park, NJ
National Provider Identifier
1992901052
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
25MA08240600 Issued in NJ
Practice address
663 Palisade Ave Ste 304
Cliffside Park, NJ 07010-3012
Phone
(201) 313-1933
Fax
(201) 313-9599
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 25MA08240600 NJ Primary

Addresses

Primary practice location

663 Palisade Ave Ste 304
Cliffside Park, NJ 07010-3012

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Other practice location 1

300 Grand Ave
Suite 202
Englewood, NJ 07631-4398
Phone (201) 503-9100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rsimon10011@njurology.direct-ci.com New Jersey Urology LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20070814000456 NJ Practitioner - Urology 7416048855 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Rutgers New Jersey Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone (201) 967-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08240600NJMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Urology LLC Urology CurrentSince Jan 1, 2010 Accepting new patients
Summit Medical Group PA CurrentSince Dec 30, 2021 Accepting new patients
Bergen County Improvement Authority CurrentSince Jul 1, 2022 Accepting new patients
Summit Medical Group PA CurrentSince Dec 30, 2021 Accepting new patients
Bergen County Improvement Authority CurrentSince Jul 1, 2022 Accepting new patients
Summit Medical Group, Inc Past Accepting new patients

Locations

36 Newark Ave
Ste 200
Belleville, NJ 07109
Phone (973) 759-6180

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

1515 Broad St
Ste B130
Bloomfield, NJ 07003
Phone (973) 842-2730

663 Palisade Ave
Ste 304
Cliffside Pk, NJ 07010
Phone (201) 313-1933

300 Grand Ave
Ste 202
Englewood, NJ 07631
Phone (201) 816-1900

75 S Dean St
Englewood, NJ 07631
Phone (201) 816-1900

230 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 225-4700

1225 McBride Ave
Woodland Park, NJ 07424
Phone (908) 277-8699

Interoperability endpoints

  • Direct secure messaging: rsimon329271@ahs.direct-ci.com
  • Direct secure messaging: rsimon10011@njurology.direct-ci.com
  • Direct secure messaging: rsimon@nj-urology.gwaydirect.com

Organizations & group practices 6

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 5

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1992901052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 PALISADE AVE STE 304",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070103012",
            "telephone_number": "201-313-1933",
            "fax_number": "201-313-9599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Grand Ave",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "NJ",
            "postal_code": "076314398",
            "country_code": "US",
            "telephone_number": "201-503-9100",
            "fax_number": "201-503-9595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "ROBERT",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA08240600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsimon10011@njurology.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "New Jersey Urology LLC",
            "address_1": "1515 Broad St",
            "address_2": "Suite B130",
            "city": "Bloomfield",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070033002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cliffside Park, NJ

Sources for this page

Verify at the official NPI Registry.