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SIMON A HOLOUBEK D.O.
NPI 1043697618
Surgery in Rockford, IL

Active since May 02, 2015PECOS EnrolledAccepts Medicare Assignment
1340 CHARLES ST STE 100&405, ROCKFORD, IL 61104(779) 696-8700 Get Directions Write a Review

NPPES record last updated: March 2, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 2, 2022, Nov 3, 2021, Sep 9, 2021 and 1 more (4 updates tracked since 2020).

About Simon A Holoubek D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SIMON A HOLOUBEK D.O. (NPI 1043697618) is an individual surgery provider in Rockford, Illinois, licensed in Illinois (036-157876) and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS, is affiliated with Uw Health, and maintains a secondary practice location in Madison.

NPPES Registry Identity

NPI1043697618
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameSIMON A HOLOUBEKCredential: D.O.
Location Address1340 CHARLES ST STE 100&405Rockford, IL 61104-2200
Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531
Phone(779) 696-8700
Sole ProprietorNo
Medical School CMSDes Moines University Of Osteopathic Medicine And Health SciencesGraduated 2015
Enumeration DateMay 2, 2015
Last NPPES UpdateMarch 2, 20224 updates tracked since enumeration
NPPES CertifiedMarch 2, 2022
✔ NPI 1043697618 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in IL · 036-157876✔ Licensed in WI · 76254
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedOtolaryngologyTaxonomy 207Y00000X · License 85540 (GA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1340 CHARLES ST STE 100&405, Rockford, IL 61104
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Secondary Practice Location 1

Location 1600 Highland AveMadison, WI 53792-1010 · Phone (608) 263-7502 · Fax (608) 263-7652

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Simon A Holoubek D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335434554
PECOS Enrollment IDI20210916001179, I20211026001357
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
18 services18 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
14 services13 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
13 services13 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Uw Health

Acute Care Hospitals · Rockford, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140228
Location1401 East State StreetRockford, IL 61104 · Winnebago County
Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Simon Holoubek's NPI number?

The NPI number for Simon Holoubek is 1043697618. It was assigned to this individual provider in the NPPES registry on May 2, 2015.

Where is Simon Holoubek located?

Simon Holoubek practices at 1340 Charles St Ste 100&405, Rockford, IL 61104. The listed phone number is (779) 696-8700.

What is Simon Holoubek's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Simon Holoubek enrolled in Medicare?

Yes. Simon Holoubek is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Simon Holoubek accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and Quartz list Simon Holoubek as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Simon Holoubek affiliated with any hospitals?

According to CMS data, Simon Holoubek is affiliated with Uw Health and University Of Wi Hospitals & Clinics Authority.

When was this NPI record last updated?

The NPPES record for Simon Holoubek was last updated on March 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.