SIMON LIPETZ MD. P.C
NPI 1235338138
Legal Medicine in Forest Hills, NY

Active since July 12, 2007CLIA 33D0865466 · Waiver
104-60 QUEENS BLVD, SUITE CH, FOREST HILLS, NY 11375(718) 275-4849(718) 275-6381 Get Directions Write a Review

NPPES record last updated: July 15, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Simon Lipetz Md. P.c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SIMON LIPETZ MD. P.C (NPI 1235338138) is a healthcare organization registered as a legal medicine in Forest Hills, New York and active in the NPI registry since July 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists Simon Lipetz, Owner, as its authorized official.

NPPES Registry Identity

NPI1235338138
Entity TypeOrganization
Primary Taxonomy173000000X
Legal Business NameSIMON LIPETZ MD. P.C
Location Address104-60 QUEENS BLVD, SUITE CHForest Hills, NY 11375
Mailing Address104-60 Queens Blvd., Suite ChForest Hills, NY 11375 · (718) 275-4849 · Fax (718) 275-6381
Fax(718) 275-6381
Organization SubpartNo
Authorized OfficialSimon LipetzOwner · (718) 275-4849
Enumeration DateJuly 12, 2007
Last NPPES UpdateJuly 15, 2014
✔ NPI 1235338138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyLegal MedicineOther Service Providers
Taxonomy Code173000000X
Licenses✔ Licensed in NY · 186190✔ Licensed in NY · 107463✔ Licensed in NY · 458751
Definition
The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.
Also ListedInternal MedicineTaxonomy 207R00000X
104-60 QUEENS BLVD, Forest Hills, NY 11375

Other Identifiers 4

Medicare UPINB78750NY
Medicare PIN00562NY
Medicare UPINB14878NY
Medicare UPINF37654NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Simon Lipetz Md. P.c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Simon Lipetz MD. P.C, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Internal Medicine
NPI 1710967393
10460 QUEENS BLVD
Forest Hills, NY 11375
(718) 275-4849
✔ PECOS✔ Accepts MedicareSame address
Diagnostic Radiology
NPI 1891746517
2270 KIMBALL ST SUITE 102
Brooklyn, NY 11234
(718) 253-6616
✔ PECOS✔ Accepts Medicare8.9 mi
Diagnostic Radiology
NPI 1144325978
1034 N BROADWAY SUITE 5
Yonkers, NY 10701
(914) 969-1818
✔ PECOS✔ Accepts Medicare17 mi
Diagnostic Radiology
NPI 1518906726
994 W SHERMAN AVE BLDG 2
Vineland, NJ 08360
(631) 534-7246
✔ PECOS✔ Accepts Medicare109 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D0865466

Simon Lipetz MD PC · Forest Hills, NY
Active · expires Aug 31, 2028
CLIA Number33D0865466
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2026
Certificate Expiration DateAugust 31, 2028
Laboratory DirectorSimon S. Lipetz
Laboratory Phone(718) 275-4849
Laboratory LocationSimon Lipetz MD PC104-60 Queens Blvd, Forest Hills, NY 11375
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Simon Lipetz MD. P.C's NPI number?

The NPI number for Simon Lipetz MD. P.C is 1235338138. It was assigned to this organization in the NPPES registry on July 12, 2007.

Where is Simon Lipetz MD. P.C located?

Simon Lipetz MD. P.C is located at 104-60 Queens Blvd Suite Ch, Forest Hills, NY 11375. The listed phone number is (718) 275-4849.

What is Simon Lipetz MD. P.C's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Is Simon Lipetz MD. P.C enrolled in Medicare?

Yes. Simon Lipetz MD. P.C is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Simon Lipetz MD. P.C?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Simon Lipetz MD. P.C. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (3) and Internal Medicine (1). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Simon Lipetz MD. P.C hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0865466) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Simon Lipetz MD. P.C was last updated on July 15, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.