Provider Demographics
NPI:1437241155
Name:SIMSA, AMY C (PA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:SIMSA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 MON HEALTH MEDICAL PARK DR STE 2300
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1134
Mailing Address - Country:US
Mailing Address - Phone:304-599-8802
Mailing Address - Fax:304-599-5607
Practice Address - Street 1:2000 MON HEALTH MEDICAL PARK DR
Practice Address - Street 2:SUITE 2300
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-599-8802
Practice Address - Fax:304-599-5607
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0111121363A00000X
WV01544363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000411871001OtherBSNENY
NY00583748Medicaid
NY000411871001OtherBSNENY
Q68545Medicare UPIN