SHIJU M SIMON (NPI# 1942677919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1942677919 |
Entity Type | Individual |
Full Name | SHIJU M SIMON |
Credential | AA-C |
Practice Address |
9330 State Road 54 Medical Center Trinity Trinity FL 34655-1808 |
Mailing Address |
5307 Main St Ste 102 New Port Richey FL 34652-2513 |
Practice Telephone | 7278481733 |
Mailing Telephone | 7278451736 |
Mailing Fax Number | 7278490759 |
Enumeration Date | 2015-08-26 |
Last Update Date | 2019-05-15 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 367H00000X | Anesthesiologist Assistant | 9220 | GA | Physician Assistants & Advanced Practice Nursing Providers |
Y | 367H00000X | Anesthesiologist Assistant | AA287 | FL | Physician Assistants & Advanced Practice Nursing Providers |
N | 367H00000X | Anesthesiologist Assistant | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 015893200 | 05 |
Street Address |
9330 STATE ROAD 54 MEDICAL CENTER TRINITY |
City | TRINITY |
State | FL |
Zip Code | 34655-1808 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891741849 | New Port Richey Hospital Inc | General Acute Care Hospital | 9330 State Road 54, Trinity, FL 34655-1808 | 2006-05-25 |
1023636495 | Angeleke Vakiaros | Pharmacist | 9330 State Road 54, Trinity, FL 34655-1808 | 2020-07-11 |
1144848649 | Jon-michael Degidio | Anesthesiologist Assistant | 9330 State Road 54, Trinity, FL 34655-1808 | 2020-07-10 |
1659900082 | Amandeep Singh | Student in an Organized Health Care Education/Training Program | 9330 State Road 54, Trinity, FL 34655-1808 | 2020-04-07 |
1023647567 | Arielle Crystal Kirk | Student in an Organized Health Care Education/Training Program | 9330 State Road 54, Trinity, FL 34655-1808 | 2020-04-06 |
1316576929 | Bir Singh | Student in an Organized Health Care Education/Training Program | 9330 State Road 54, Trinity, FL 34655-1808 | 2020-04-06 |
1407485097 | Duncan Lee Bralts | Student in an Organized Health Care Education/Training Program | 9330 State Road 54, Trinity, FL 34655-1808 | 2020-04-06 |
1164051058 | Heba Yusuf | Student in an Organized Health Care Education/Training Program | 9330 State Road 54, Trinity, FL 34655-1808 | 2020-04-03 |
1932738770 | Donald Anthony Gygi | Student in an Organized Health Care Education/Training Program | 9330 State Road 54, Trinity, FL 34655-1808 | 2020-04-03 |
1437788296 | Amira Athanasios | Student in an Organized Health Care Education/Training Program | 9330 State Road 54, Trinity, FL 34655-1808 | 2020-04-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245845221 | Kathryn E Wright | Social Worker | 8225 Florida State Road 54, New Port Richey, FL 34655 | 2020-09-15 |
1245873728 | Trinity Counseling Services | Marriage & Family Therapist | 1934 Duck Slough, Trinity, FL 34655 | 2019-10-28 |
1134770563 | Timothy Foster | Licensed Practical Nurse | 9332 Sr 54, Ste 202, Trinity, FL 34655 | 2019-09-26 |
1710542824 | Leah E. Grossman | Student in an Organized Health Care Education/Training Program | Medical Center of Trinity, 9330 State Rd 54, Trinity, FL 34655 | 2019-05-03 |
1508420696 | Varun Reddy | Student in an Organized Health Care Education/Training Program | 9330 Fl 54, Trinity, FL 34655 | 2019-04-24 |
1184183642 | Courtney Lynne Fagan | Specialist/Technologist | 8225 Fl-54, New Port Richey, FL 34655 | 2019-03-14 |
1164996633 | Brooke E Cox | Obstetrics & Gynecology | 8145 Cerebellum Way Ste 102, Trinity, FL 34655 | 2019-01-17 |
1144734591 | Optimal Performance and Physical Therapies Trinity LLC | Physical Therapist | 11157 Trinity Blvd, Trinity, FL 34655 | 2017-11-21 |
1629581285 | Nationwide Vision Center, LLC | Technician/Technologist | 3238 Little Rd, Trinity, FL 34655 | 2017-11-06 |
1053834267 | Spnn LLC | Pharmacy | 5429 Little Rd, New Port Richey, FL 34655 | 2017-07-19 |
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Taxonomy Code | 367H00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Anesthesiologist Assistant |
An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144848649 | Jon-michael Degidio | Anesthesiologist Assistant | 9330 State Road 54, Trinity, FL 34655-1808 | 2020-07-10 |
1972157824 | Nastassia G Baltodano | Anesthesiologist Assistant | 9330 State Road 54, Trinity, FL 34655-1808 | 2019-07-30 |
1558914051 | Cynthia Siyomvo | Anesthesiologist Assistant | 9330 State Road 54, Trinity, FL 34655-1808 | 2019-07-23 |
1609438316 | Bradlee Fagerberg | Anesthesiologist Assistant | 9330 Fl-54, Trinity, FL 34655 | 2019-07-02 |
1396302121 | Mark Anthony Leonard | Anesthesiologist Assistant | 9330 State Road 54, Medical Center of Trinity, Trinity, FL 34655 | 2019-05-28 |
1528437084 | Devin Capristo | Anesthesiologist Assistant | 9330 State Road 54, Trinity, FL 34655-1808 | 2015-09-15 |
1376922161 | Kristin Avanell Beck | Anesthesiologist Assistant | 2102 Trinity Oaks Blvd, Trinity, FL 34655-4409 | 2015-05-26 |
1346591526 | Justin Lee Drobisch | Anesthesiologist Assistant | 9330 State Road 54, Trinity, FL 34655-1808 | 2012-09-27 |
1376893123 | Sebastien Charles | Anesthesiologist Assistant | 9330 State Road 54, Trinity, FL 34655-1808 | 2012-09-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437761798 | Wayleniz Rosario Falero | Anesthesiologist Assistant | 331 Sw 19th Ln, Cape Coral, FL 33991-3784 | 2020-08-18 |
1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
1821616228 | Katherine Tchir | Anesthesiologist Assistant | 851 Trafalgar Court Suite 200e, Maitland, FL 32751 | 2020-07-12 |
1992327308 | Daniel Le Phan | Anesthesiologist Assistant | 800 Prudential Dr Fl 32207, Jacksonville, FL 32207-8202 | 2020-05-08 |
1497395412 | Charles Joshua Thrower | Anesthesiologist Assistant | 1 Shircliff Way # Wat, Jacksonville, FL 32204-4748 | 2020-01-07 |
1194372227 | Matthew Zachary Laribee | Anesthesiologist Assistant | 7900 N Kendall Dr, Miami, FL 33156-7457 | 2019-08-22 |
1659856862 | Ian Michael Durham | Anesthesiologist Assistant | 1 Shircliff Way Fl 32204, Jacksonville, FL 32204-4748 | 2018-10-03 |
1386138287 | Stephen Johnson | Anesthesiologist Assistant | 157 Dawn Lauren Ln, Tallahassee, FL 32301-3415 | 2018-06-15 |
1164910691 | Heather Berman | Anesthesiologist Assistant | 209 Bristol Ct, Tavernier, FL 33070-2838 | 2018-04-30 |
1710437561 | Alyssa Scheidecker | Anesthesiologist Assistant | 12305 Hawthorne View Court, Tampa, FL 33626 | 2016-10-05 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.