Healthcare Provider Details

I. General information

NPI: 1245807957
Provider Name (Legal Business Name): THOMAS JASON SENDRIJAS SIMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 PERDIDO ST FL 5
NEW ORLEANS LA
70112-1352
US

IV. Provider business mailing address

2021 PERDIDO ST FL 5
NEW ORLEANS LA
70112-1352
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-4624
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number12985
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number346175
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: