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Dr. Peter John Simon , MD

Pediatrics β€’ San Rafael, CA

Active NPI 1114244175 Individual Practitioner Male Practitioner
Practice location in NPPES

3110 Kerner Blvd
San Rafael, CA 949015411

Call 4154481500 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3110 Kerner Blvd

San Rafael, CA 949015411

Telephone 4154481500
Organization at the Same NPPES Address or Phone
Marin Community Clinic Facility NPI 1154503399

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2010

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Simon has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Simon as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in San Rafael and California

22 active clinicians are listed under Pediatrics with a practice address in San Rafael, CA (9,280 in California).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in San Rafael

0% of these 22 clinicians have the CMS telehealth indicator.

4.5% of these 22 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-04-22
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES CA A120382

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Medical Board of California.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20151210001525

Enrollment State Jurisdiction

CA

PECOS Control ID

5890096119

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

25 listed
Dr. Alaric Akashi , MD

Internal Medicine

NPI 1285784264

Doctor of Medicine (M.D.)

Claudia Awamleh , FNP

Nurse Practitioner - Family

NPI 1881168714

Family Nurse Practitioner

Lara Barth , FNP

Family Medicine

NPI 1023607397

Family Nurse Practitioner

NPI 1013414507

Doctor of Osteopathic Medicine (D.O.)

Dr. Nicole Betenia , MD MPH

Obstetrics & Gynecology

NPI 1316309511

MDMPH

Joleen Bishop , NP

Nurse Practitioner - Women's Health

NPI 1295737435

Nurse Practitioner

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location April 22, 2026

Registered at 3110 KERNER BLVD, SAN RAFAEL, CA 949015411 (Tel: 4154481500)

πŸ“
Updated Business Mailing Address April 22, 2026

Registered at 3110 KERNER BLVD, SAN RAFAEL, CA 949015411 (Tel: 4154481500)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 22, 2026

Pediatrics (license number reported to NPPES: CA A120382)

βœ…
NPI Profile Active April 29, 2010

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 29, 2010

Registered at 505 PARNASSUS AVE, SAN FRANCISCO, CA 941432204 (Tel: 4154765001)

πŸ“
Business Mailing Address (Initial Record) April 29, 2010

Registered at 11 DOLORES ST, APT 2, SAN FRANCISCO, CA 941031061 (Tel: 6502964143)

πŸ‘€
Provider Name / Credentials (Initial Record) April 29, 2010

Recorded as PETER SIMON, M.D.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 29, 2010

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration April 29, 2010

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1114244175
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 29, 2010
Last Update: April 22, 2026
Sole Proprietor: Yes

Mailing Address

3110 Kerner Blvd

San Rafael, CA 949015411

Phone: 4154481500

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.