DR. SEGUN V SIMON (NPI# 1194956490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194956490 |
| Entity Type | Individual |
| Full Name | DR. SEGUN V SIMON |
| Credential | MD |
| Practice Address |
2130 Millburn Ave Suite C-3 Maplewood NJ 07040-3725 |
| Mailing Address |
Po Box 373 Short Hills NJ 07078-0373 |
| Practice Telephone | 9739962727 |
| Practice Fax Number | 9737632558 |
| Mailing Telephone | 9739962727 |
| Mailing Fax Number | 9737632558 |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2014-11-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
25MA08683000 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0371254 | 05 |
| Street Address |
2130 MILLBURN AVE SUITE C-3 |
| City | MAPLEWOOD |
| State | NJ |
| Zip Code | 07040-3725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720062227 | Michael Goldfarb | Internal Medicine | 2130 Millburn Ave, C6, Maplewood, NJ 07040-3725 | 2005-11-30 |
| 1306471016 | Reveal 2 Heal Consulting Services LLC | Counselor | 2130 Millburn Ave, Maplewood, NJ 07040-3725 | 2020-03-03 |
| 1508381930 | Helping Hand Disability Services | Case Management | 2130 Millburn Ave, Maplewood, NJ 07040-3725 | 2017-08-07 |
| 1942747159 | Chinarie Jones | Social Worker | 2130 Millburn Ave, Suite D-1, Maplewood, NJ 07040-3725 | 2017-01-25 |
| 1336699529 | Kira Baskerville-williams | Social Worker | 2130 Millburn Ave, Ste D-2, Maplewood, NJ 07040-3725 | 2016-10-11 |
| 1598215790 | Ruby Baskerville | Social Worker | 2130 Millburn Ave, Ste D-2, Maplewood, NJ 07040-3725 | 2016-10-11 |
| 1962863662 | Complete Kidney Care LLC | Specialist | 2130 Millburn Ave, Suite C11, Maplewood, NJ 07040-3725 | 2016-03-09 |
| 1174981948 | Aunjuli A. Hicks Lpc Limited Liability Company | Counselor | 2130 Millburn Ave, Ste C8, Maplewood, NJ 07040-3725 | 2016-02-08 |
| 1922473511 | Calloway Speech Language Services, LLC | Speech-Language Pathologist | 2130 Millburn Ave, Suite D-1, Maplewood, NJ 07040-3725 | 2015-12-08 |
| 1649640897 | Carolyn Davis-cottle | Social Worker | 2130 Millburn Ave, Maplewood, NJ 07040-3725 | 2015-09-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538654462 | Ajibola G Alli | Counselor | 15 Hausmann Ct Fl 1, Maplewood, NJ 07040 | 2018-06-23 |
| 1487142980 | Monica Goodrich | Student in an Organized Health Care Education/Training Program | Winchester Gardens, 333 Elmwood Ave, Maplewood, NJ 07040 | 2018-04-30 |
| 1487173795 | Jessica M Hodge | Marriage & Family Therapist | 35 Marie Place, Maplewood, NJ 07040 | 2017-09-18 |
| 1386173797 | Marianne Nadine Rubino | Social Worker | 111 Dunnell Road, Suite 201-8, Maplewood, NJ 07040 | 2017-06-08 |
| 1629504881 | Krishna Surapaneni | Pharmacist | 747 Irvington Avenue, Maplewood, NJ 07040 | 2017-05-10 |
| 1548717143 | Mindset Psychotherapy Center | Social Worker | 2040 Millburn Ave. Suite 205, Maplewood, NJ 07040 | 2016-09-01 |
| 1588010888 | Rochelle Laverne Brunson | Massage Therapist | 2130 Millburn Ave., Suite C8, Maplewood, NJ 07040 | 2016-05-05 |
| 1881082774 | Perry Grossman | Physical Medicine & Rehabilitation | 137 Parker Avenue, Maplewood, NJ 07040 | 2014-12-31 |
| 1124436746 | Karen Reckson | Specialist | 24 Beach Place, Maplewood, NJ 07040 | 2014-07-28 |
| 1427462670 | Appetite for Health | Dietitian, Registered | 94 Claremont Ave, Maplewood, NJ 07040 | 2014-06-16 |
| Find all providers in zip 07040 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912547761 | Associated Dialysis Consultants LLC | Internal Medicine | 1997 Sloan Pl Ste 17, Maplewood, MN 55117-2051 | 2020-01-09 |
| 1871918615 | Kidney Care Pa | Internal Medicine | 2130 Millburn Ave, Suite C3, Maplewood, NJ 07040-3725 | 2014-03-04 |
| 1326236647 | Kodali Nephrology and Hypertention Center LLC | Internal Medicine | 2040 Millburn Ave, Suite 403, Maplewood, NJ 07040-3726 | 2007-10-11 |
| 1104976158 | Associated Nephrology Consultants, P.a. | Internal Medicine | 1997 Sloan Place, Suite 17, Maplewood, MN 55117-2051 | 2007-01-11 |
| 1790747764 | Padmaja Kodali | Internal Medicine | 2040 Millburn Ave, Suite 403, Maplewood, NJ 07040-3726 | 2006-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091878 | Vitality Medical Associates | Internal Medicine | 561 East 28th Street, Paterson, NJ 07504-1862 | 2020-10-21 |
| 1396377784 | Dr Walead Latif Professional Corporation | Internal Medicine | 1 Thistle Ln, Warren, NJ 07059-5564 | 2020-02-04 |
| 1225508203 | Arianna Hope Sanborn | Internal Medicine | 1261 Route 38 Ste A, Hainesport, NJ 08036-2702 | 2018-12-03 |
| 1518417203 | Ajay Singh | Internal Medicine | 6 Bradford Ct, West Windsor, NJ 08550-3032 | 2016-10-06 |
| 1124571849 | Kathryn Anne Feldenzer | Internal Medicine | 41 Endicott Rd, Hamilton Square, NJ 08690-2145 | 2016-07-28 |
| 1104272368 | Aruna Yeldanidi Md LLC | Internal Medicine | 19 Cornell Dr, Livingston, NJ 07039-5504 | 2016-05-06 |
| 1972997146 | Adedamola Moji Adeboye | Internal Medicine | 111 Northfield Ave Ste 311, West Orange, NJ 07052-4703 | 2015-03-25 |
| 1457757726 | Vascular Access Center of Central New Jersey LLC | Internal Medicine | 1 Wills Way, Piscataway, NJ 08854-3770 | 2014-11-13 |
| 1851706410 | Eric S. Cantor | Internal Medicine | 1 Cedar Brook Drive, Cranbury, NJ 08512 | 2014-06-23 |
| 1821410192 | Lilian Saro-nunez | Internal Medicine | 360 Essex St Ste 304, Hackensack, NJ 07601-8566 | 2014-01-06 |
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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.