SIMON MICHAEL FITZGERALD MPH
NPI 1407140767
Student in an Organized Health Care Education/Training Program in Brooklyn, NY
About Simon Michael Fitzgerald Mph NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SIMON MICHAEL FITZGERALD MPH (NPI 1407140767) is an individual student in an organized health care education/training program in Brooklyn, New York, licensed in New York (12322090) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Simon Michael Fitzgerald Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Simon Fitzgerald reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Elmhurst, NY 11373
- Reassigned Medicare billing, New York enrollment
- 836 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BROOKLYN, NY 11203
BROOKLYN, NY 11203
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 Fitzgerald's NPI number?
The NPI number for Simon Fitzgerald is 1407140767. It was assigned to this individual provider in the NPPES registry on June 4, 2011.
Where is Simon Fitzgerald located?
Simon Fitzgerald practices at 450 Clarkson Ave, Brooklyn, NY 11203. The listed phone number is (410) 466-1713.
What is Simon Fitzgerald's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Simon Fitzgerald enrolled in Medicare?
Yes. Simon Fitzgerald is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Simon Fitzgerald's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Simon Fitzgerald reassigns Medicare benefits to Icahn School Of Medicine At Mount Sinai (Elmhurst, NY). The 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 Simon Fitzgerald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Simon Fitzgerald was last updated on June 4, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Simon Michael Fitzgerald, MPH · NPI 1407140767
Student in an Organized Health Care Education/Training Program provider in Brooklyn, New York. Individual provider, active in the CMS NPPES registry since June 4, 2011.
## Identity
- **NPI:** 1407140767 (Entity type: Individual)
- **Enumerated:** June 4, 2011
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **State license:** 12322090 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 450 CLARKSON AVE, Brooklyn, NY 11203-2012
- **Phone:** (410) 466-1713
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Icahn School Of Medicine At Mount Sinai (NPI 1346721289, Elmhurst, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 4, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1407140767) · Data from the CMS NPPES public registry.