MEDICARE: JANET E SIMON DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	223	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NM005430	OTHER	NM	BLUE CROSS BLUE SHIELD
2	25842	OTHER	NM	PRESBYTERIAN HEALTH PLAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316943897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET E SIMON DPM

Provider Business Mailing Address
First Line	:	4343 PAN AMERICAN FWY NE
Second Line	:	STE 234
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-6834
Country	:	US
Telephone Number	:	505-880-1000
Fax Number	:	505-880-1002

Provider Business Practice Location Address
First Line	:	8300 CARMEL AVE NE
Second Line	:	STE 501
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87122-3125
Country	:	US
Telephone Number	:	505-797-1001
Fax Number	:	505-828-1571

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	08/29/2022

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Directions to “ JANET E SIMON DPM” Practice Location

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