SHIJU M SIMON (AA-C) – Anesthesiologist Assistant, NPI 1942677919
Anesthesiologist Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
936 ANESTHESIOLOGY ASSISTANT in FL
Provider Addresses for SHIJU M SIMON (AA-C)
9330 State Road 54
Medical Center Trinity
Trinity, FL 346551808
Phone: (727) 848-1733
Type: Location
5307 MAIN ST
STE 102
NEW PORT RICHEY, FL 346522513
Phone: (727) 845-1736
Fax: (727) 849-0759
Type: Mailing
9330 STATE ROAD 54
MEDICAL CENTER TRINITY
TRINITY, FL 346551808
Phone: (727) 848-1733
Type: Location
362 GRASSMEADE WAY
SNELLVILLE, GA 300787782
Phone: (404) 271-7507
Type: Mailing
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 300467694
Phone: (678) 312-1000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $148.
Total Amount is formed as General ($148) + Research ($0) + Ownership ($0) = $148.
Last reported payment date: 2024-10-16 • Largest payer in this snapshot: Becton, Dickinson and Company ($131).
Total Amount
$148
General + Research + Ownership
Payments
2
Total payment records
General Amount
$148
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Becton, Dickinson and Company | $131 |
| Haemonetics Corporation | $17 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-06-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190611003011 | I | Anesthesiology Assistant | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 34655)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ANESTHESIOLOGY ASSISTANT | FL | 00790 | Anesthesia for procedure in upper abdomen including use of an endoscope | 12 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Anesthesiology Assistant | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Internal Medicine, Infectious Disease | GA | |
| - | GA | |
| - | GA | |
| Physician Assistant | GA | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| N E U R O L O G Y | GA |
Reviews
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