Physician Compare National (NPI:1740266972)

HEALTHCARE PROVIDER: RONALD DAVID SIMON DO

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1740266972
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294740536
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110901000696
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SIMON
	Individual professional last name
Provider First Name	RONALD
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DO
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1995 ERRECART BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 208
	Group Practice or individual's line 2 address
City	ELKO
	Group Practice or individual's city
State	NV
	Group Practice or individual's state
Zip Code	898018337
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	290008
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTHEASTERN NEVADA REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y