TARA LEIGH SIMON DNP, CRNA
NPI 1649991126
Nurse Anesthetist, Certified Registered in Petoskey, MI

Q: What is Tara Simon's NPI number?

The NPI number for Tara Simon is 1649991126. It was assigned to this individual provider in the NPPES registry on September 5, 2022.

Q: What is Tara Simon's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Tara Simon was last updated on June 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.

Active since September 05, 2022Accepts Medicare Assignment

416 CONNABLE AVE, PETOSKEY, MI 49770(231) 348-2795(231) 348-2031 Get Directions Write a Review

NPPES record last updated: June 1, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 1, 2026, May 6, 2026, Sep 5, 2022 (3 updates tracked since 2022).

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About Tara Leigh Simon Dnp, Crna NPPES

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

TARA LEIGH SIMON DNP, CRNA (NPI 1649991126) is an individual nurse anesthetist, certified registered in Petoskey, Michigan, licensed in Michigan (4704326900) and active in the NPI registry since September 2022. She is affiliated with Mclaren Northern Michigan and is a graduate of Oakland Univ, William Beaumont School Of Medicine (2025).

NPPES Registry Identity

NPI1649991126

Entity TypeIndividualFemale

Primary Taxonomy367500000X

Provider Legal NameTARA LEIGH SIMONCredential: DNP, CRNA

Location Address416 CONNABLE AVEPetoskey, MI 49770-2212

Mailing Address602 Jackson StPetoskey, MI 49770-2220 · (231) 348-2795 · Fax (231) 348-2031

Phone(231) 348-2795

Fax(231) 348-2031

Sole ProprietorNo

Medical School CMSOakland Univ, William Beaumont School Of MedicineGraduated 2025

Enumeration DateSeptember 5, 2022

Last NPPES UpdateJune 1, 20263 updates tracked since enumeration

NPPES CertifiedJune 1, 2026

✔ NPI 1649991126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in MI · 4704326900

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Also ListedRegistered Nurse · Critical Care MedicineTaxonomy 163WC0200X · License 4704326900 (MI)

416 CONNABLE AVE, Petoskey, MI 49770

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tara Leigh Simon Dnp, Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527566173

PECOS Enrollment IDI20250812003435

Medicare Billing Reassignment

Medicare enrollment records show Tara Simon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Northern Anesthesia Providers PC

0.2 mi

Anesthesiology

602 JACKSON ST
Petoskey, MI 49770

Reassigned Medicare billing, Michigan enrollment
39 clinicians in this Medicare group

NPI 1396834628 (231) 348-2795

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mclaren Northern Michigan

Acute Care Hospitals · Petoskey, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230105

Location416 Connable AvePetoskey, MI 49770 · Emmet County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49770 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.15 typical visit price

range $54.34 – $166.68

Typical copayment $31.53 (range $13.58 – $41.67)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

KEELY MARIE BLOSH NP

Nurse Practitioner