Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Simon Correa Gaviria, MD, MMSC

Individual provider Nephrology Physician · NPI 1124601042

Dr. Simon Correa Gaviria, MD, MMSC is a Nephrology in New Haven, Connecticut. Qualified in 2014, 12 years ago. Works from 2 locations. Licensed in Massachusetts.

Years since qualifying
12
Licensed in
MA
In the registry since
2021
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

20 York St
New Haven, CT 06510-3220
Phone: (203) 688-4242
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 165 Cambridge St, Boston, MA 02114-2783 — (617) 726-5050

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence 1027330 (MA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 1027330 (MA)

Record details

NPI number1124601042
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , MMSC
Sole proprietorNo
NPI enumeratedApril 29, 2021
Last updated in NPPESJune 11, 2026
Certification dateJune 11, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Not indicated

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