Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shiju M Simon, AA-C

Individual provider Anesthesiologist Assistant · NPI 1942677919

Shiju M Simon, AA-C is an Anesthesiology Assistant in Lawrenceville, Georgia. Qualified in 2015, 11 years ago. Practices with Emory Specialty Associates, LLC, a 694-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida and Georgia.

Years since qualifying
11
Licensed in
FL, GA
In the registry since
2015
Specialties on file
3
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Practice location Address checks out

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone: (678) 312-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9330 State Road 54, Trinity, FL 34655-1808 — (727) 848-1733

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X · Licence 9220 (GA)
Anesthesiologist Assistant Taxonomy 367H00000X · Licence AA287 (FL)
Anesthesiologist Assistant Taxonomy 367H00000X

Record details

NPI number1942677919
Entity typeIndividual (Type 1)
GenderMale
Credentials AA-C
Sole proprietorNo
NPI enumeratedAugust 26, 2015
Last updated in NPPESMarch 22, 2023
Certification dateMarch 22, 2023

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Emory Specialty Associates, Llc — 694 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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