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KEVIN SIMMONS
NPI 1063195543
Nurse Practitioner - Family in Banning, CA

Active since August 10, 2023PECOS Enrolled
264 N HIGHLAND SPRINGS AVE STE 1B, BANNING, CA 92220(951) 769-7191 Get Directions Write a Review

NPPES record last updated: December 20, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kevin Simmons NPPES

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

KEVIN SIMMONS (NPI 1063195543) is an individual family provider in Banning, California, licensed in California (95025928) and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1063195543
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameKEVIN SIMMONS
Location Address264 N HIGHLAND SPRINGS AVE STE 1BBanning, CA 92220-3045
Mailing Address264 N Highland Springs Ave Ste 1bBanning, CA 92220-3045
Phone(951) 769-7191
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateAugust 10, 2023
Last NPPES UpdateDecember 20, 2023
NPPES CertifiedDecember 20, 2023
✔ NPI 1063195543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95025928
264 N HIGHLAND SPRINGS AVE STE 1B, Banning, CA 92220
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Simmons is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8123599537
PECOS Enrollment IDI20260607000050
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.

Medicare Billing Reassignment

Medicare enrollment records show Kevin Simmons reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grace Family Health, Inc.
28 mi
Primary Care
24910 LAS BRISAS RD, SUITE 105
Murrieta, CA 92562
  • Reassigned Medicare billing, California enrollment
  • 6 clinicians in this Medicare group
NPI 1033426028 (951) 231-1385

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92220 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
Most-billed visit code 99214
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 Kevin Simmons's NPI number?

The NPI number for Kevin Simmons is 1063195543. It was assigned to this individual provider in the NPPES registry on August 10, 2023.

Where is Kevin Simmons located?

Kevin Simmons practices at 264 N Highland Springs Ave Ste 1B, Banning, CA 92220. The listed phone number is (951) 769-7191.

What is Kevin Simmons's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kevin Simmons enrolled in Medicare?

Yes. Kevin Simmons is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kevin Simmons's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Simmons reassigns Medicare benefits to Grace Family Health, Inc. (Murrieta, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin Simmons's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kevin Simmons was last updated on December 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.