RICHARD J SIMMONS MD
NPI 1003827080
Pathology - Anatomic Pathology & Clinical Pathology in Scottsbluff, NE
NPI Status: Active since August 11, 2006
Contact Information
4021 AVENUE B
SCOTTSBLUFF, NE
ZIP 69361
Phone: (308) 630-1400
Fax: (308) 632-7830
- Individual
- Male
- Pathology
- Anatomic Pathology & Clinical Pathology
- PECOS Enrolled
About RICHARD SIMMONS
This page provides the complete NPI Profile along with additional information for Richard Simmons, a provider established in Scottsbluff, Nebraska with a medical specialization in Pathology, focusing in anatomic pathology & clinical pathology . The healthcare provider is registered in the NPI registry with number 1003827080 assigned on August 2006. The practitioner's primary taxonomy code is 207ZP0102X with license number 18303 (NE). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1003827080
- Provider Name
- RICHARD J SIMMONS MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4021 AVENUE B SCOTTSBLUFF, NE 69361
- Location Phone
- (308) 630-1400
- Location Fax
- (308) 632-7830
- Mailing Address
- PO BOX 1886 SCOTTSBLUFF, NE 69361
- Mailing Phone
- (308) 630-1400
- Mailing Fax
- (308) 632-7830
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-11-2006
- Last Update Date
- 11-16-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pathology Anatomic Pathology & Clinical Pathology
- Taxonomy Code
- 207ZP0102X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 18303
- License State
- NE
- Taxonomy Description
- A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | 4983 (SD) |
| 2 | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | 5935A (WY) |
| 3 | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | 25521 (CO) |
| 4 | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | G54216 (CA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2714 | OTHER (01) | BCBS (CLASSIC AND PREFERR | |
| 090114 | MEDICARE PIN (08) | NE | |
| 10453118 00 | MEDICAID (05) | WY | |
| 4983 | OTHER (01) | SD | DAKOTACARE |
| 7706270 | MEDICAID (05) | SD | |
| C04303 | MEDICARE UPIN (02) |
Medicare Participation & PECOS Enrollment Status
Richard Simmons is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Blood smear interpretation by physician with written report
Cell examination of specimen, selective cellular enhancement technique
Pathology clinical consultation for clinical problem, 5-20 minutes
Pathology examination of tissue using a microscope, intermediate complexity
Pathology examination of tissue using a microscope, moderately high complexity
Pathology examination of tissue using a microscope, moderately low complexity
Special stained specimen slides to examine tissue, each additional procedure
Special stained specimen slides to examine tissue, initial procedure
Blood smear interpretation is a lab test where your doctor examines a sample of your blood under a microscope. They look for abnormalities in your blood cells which can help diagnose various conditions. You'll receive a written report of the findings.
This service was performed 15 times for 15 patientsCell examination of a specimen using selective cellular enhancement technique is a lab process that improves the visibility of certain cells in a sample. It helps in identifying abnormalities or diseases. The process is non-invasive, safe, and aids in accurate diagnosis.
This service was performed 29 times for 27 patientsA pathology clinical consultation is a brief meeting with a medical expert to discuss health concerns. The consultation, lasting between 5-20 minutes, involves reviewing your medical history and possibly conducting tests to diagnose or understand your health condition better.
This service was performed 25 times for 25 patientsA pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
This service was performed 478 times for 282 patientsA pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.
This service was performed 39 times for 29 patientsA pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.
This service was performed 30 times for 27 patientsSpecial stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.
This service was performed 131 times for 30 patientsThis procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.
This service was performed 124 times for 101 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 69361 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $121.35
- Minimum New Patient Price $52.69
- Maximum New Patient Price $160.21
- Average New Patient Copayment $30.33
- Minimum New Patient Copayment $13.17
- Maximum New Patient Copayment $40.05
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.55
- Minimum Established Patient Price $16.9
- Maximum Established Patient Price $131.25
- Average Established Patient Copayment $23.38
- Minimum Established Patient Copayment $4.22
- Maximum Established Patient Copayment $32.81
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003827080, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SCOTTSBLUFF, NE 69361
SCOTTSBLUFF, NE 69361
SCOTTSBLUFF, NE 69361
SCOTTSBLUFF, NE 69361
SCOTTSBLUFF, NE 69361
SCOTTSBLUFF, NE 69361
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003827080, enumerated as an "individual" on August 11, 2006.
The provider is located at 4021 AVENUE B SCOTTSBLUFF, NE 69361 and the phone number is (308) 630-1400.
Pathology with taxonomy code 207ZP0102X and a focus in Anatomic Pathology & Clinical Pathology.
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
