DR. SCOTT SIMECEK II D.O.
NPI 1104865765
Internal Medicine - Pulmonary Disease in Clarkston, MI

Q: What is Scott Simecek's NPI number?

The NPI number for Scott Simecek is 1104865765. It was assigned to this individual provider in the NPPES registry on June 6, 2006.

Q: What is Scott Simecek's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Scott Simecek was last updated on February 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since June 06, 2006PECOS EnrolledAccepts Medicare Assignment

5701 BOW POINTE DR, STE 365, CLARKSTON, MI 48346(248) 922-9283(248) 922-9286 Get Directions Write a Review

NPPES record last updated: February 5, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Scott Simecek Ii D.o. NPPES

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

DR. SCOTT SIMECEK II D.O. (NPI 1104865765) is an individual pulmonary disease provider in Clarkston, Michigan, licensed in Michigan (5101011869) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence Hospital, Southfield And Novi, and is a graduate of R Franklin University Of Med & Sci/chicago Medical School (1992).

NPPES Registry Identity

NPI1104865765

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. SCOTT SIMECEK IICredential: D.O.

Location Address5701 BOW POINTE DR, STE 365Clarkston, MI 48346-3198

Mailing Address5701 Bow Pointe Dr Ste 365Clarkston, MI 48346-5403 · (248) 922-9283 · Fax (248) 922-9286

Phone(248) 922-9283

Fax(248) 922-9286

Sole ProprietorNo

Medical School CMSR Franklin University Of Med & Sci/chicago Medical SchoolGraduated 1992

Enumeration DateJune 6, 2006

Last NPPES UpdateFebruary 5, 2020

✔ NPI 1104865765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in MI · 5101011869

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 5101011869 (MI)

Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 5101011869 (MI)

5701 BOW POINTE DR, Clarkston, MI 48346

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Other Identifiers 1

Medicaid4234474MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community 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

Dr. Scott Simecek Ii 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 ID9032143607

PECOS Enrollment IDI20050922001054

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 13

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

389 services213 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.

217 services98 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

196 services73 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.

108 services94 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

98 services95 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

96 services93 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

95 services92 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

86 services85 patients

Sleep study including heart rate, breathing, and sleep time 95800

A sleep study monitors your sleep patterns to evaluate your sleep quality. It records your heart rate, breathing, and actual sleep time. This information helps identify any sleep disorders, ensuring you get the rest you need for optimal health.

56 services56 patients

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.

51 services51 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

35 services28 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

25 services23 patients

Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811

A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.

17 services15 patients

Hospital Affiliations CMS Care Compare 4

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

Ascension Providence Hospital, Southfield And Novi

Acute Care Hospitals · Southfield, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230019

Location16001 W Nine Mile RdSouthfield, MI 48075 · Oakland County

Emergency services Birthing friendly

Trinity Health Oakland Hospital

Acute Care Hospitals · Pontiac, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230029

Location44405 Woodward AvePontiac, MI 48341 · Oakland County

Emergency services Birthing friendly

Mclaren Oakland

Acute Care Hospitals · Pontiac, MI

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230207

Location50 N Perry StPontiac, MI 48342 · Oakland County

Emergency services

Huron Valley-Sinai Hospital

Acute Care Hospitals · Commerce Township, MI

3/5 CMS rating

OwnershipProprietary

CMS Certification Number230277

LocationOne William Carls DriveCommerce Township, MI 48382 · Oakland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48346 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

$134.28 typical visit price

range $58.04 – $177.36

Typical copayment $33.57 (range $14.51 – $44.34)

Most-billed visit code 99204

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)

Percentage of patients, aged 18 years and older, with a diagnosis of acute viral sinusitis who were prescribed an antibiotic within 10 days after onset of symptoms

Lower rates are better for this measure.

76%21 patients1/55-star benchmark: 100%

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

1%531 patients1/55-star benchmark: 100%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

3%702 patients1/55-star benchmark: 85%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

96%2,598 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

75%118 patients4/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

100%264 patients5/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

49%1,125 patients3/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

26%1,123 patients2/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

47%976 patients3/55-star benchmark: 88%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

81%1,125 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

4%1,125 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

23%1,125 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 27

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

17 suppliers158 claims158 services$30.19 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

13 suppliers101 claims101 services$68.50 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

12 suppliers93 claims200 services$25.89 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

13 suppliers53 claims254 services$13.67 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

14 suppliers85 claims439 services$12.08 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

20 suppliers155 claims155 services$42.95 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

23 suppliers149 claims149 services$14.82 avg. paid by Medicare

Chinstrap used with positive airway pressure device A7036

DME-Other DME · category DE001N

11 suppliers17 claims17 services$8.63 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

16 suppliers92 claims93 services$9.63 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

25 suppliers224 claims1,161 services$1.60 avg. paid by Medicare

Filter, non disposable, used with positive airway pressure device A7039

DME-Other DME · category DE001N

7 suppliers19 claims19 services$4.88 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

19 suppliers112 claims112 services$11.35 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

10 suppliers110 claims112 services$15.11 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$34.52 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

3 suppliers26 claims26 services$74.80 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0471

DME-Other DME · category DE001N

2 suppliers19 claims19 services$172.81 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

8 suppliers66 claims67 services$10.21 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

8 suppliers47 claims54 services$4.60 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

16 suppliers170 claims179 services$26.23 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

15 suppliers251 claims256 services$64.92 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

4 suppliers104 claims107 services$29.73 avg. paid by Medicare

Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605

DME-Drugs Administered Through DME · category DG006N

6 suppliers39 claims2,220 services$4.47 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

9 suppliers44 claims9,706 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

4 suppliers18 claims1,980 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

5 suppliers41 claims2,406 services$0.79 avg. paid by Medicare

Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677

DME-Drugs Administered Through DME · category DG006N

3 suppliers29 claims152,250 services$0.15 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

12 suppliers91 claims91 services$25.47 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GARY S KWARTOWITZ D.O.

Otolaryngology

5701 BOW POINTE DR, SUITE 200
CLARKSTON, MI 48346

Oakland County (248) 620-3100

CLARKSTON DERMATOLOGY & VEIN CENTER PLLC

Dermatology

5701 BOW POINTE DR, SUITE 215
CLARKSTON, MI 48346

Oakland County (248) 620-3376

NORTH OAKLAND EAR NOSE &THROAT CENTERS PC

Otolaryngology

5701 BOW POINTE DR, SUITE 200
CLARKSTON, MI 48346

Oakland County (248) 620-3100

DR. TIMOTHY R ONEILL DO

Family Medicine

5701 BOW POINTE DR, SUITE 100
CLARKSTON, MI 48346

Oakland County (248) 625-2621

MRS. SUSAN LOUISE CLARK NP

Nurse Practitioner (Psychiatric/Mental Health)

5701 BOW POINTE DR, SUITE 225
CLARKSTON, MI 48346

Oakland County (248) 384-8300

WILLIAM E RIZZO MD

Internal Medicine

5701 BOW POINTE DR, SUITE 120
CLARKSTON, MI 48346

Oakland County (248) 625-2273

DR. NAVEEN GUNDA REDDY M.D.

Internal Medicine (Gastroenterology)

5701 BOW POINTE DR, SUITE 370
CLARKSTON, MI 48346

Oakland County (248) 625-4055

VASCULAR SURGERY ASSOC, P.C.

Surgery (Vascular Surgery)

5701 BOW POINTE DR, SUITE 2010
CLARKSTON, MI 48346

Oakland County (248) 620-3900

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 Scott Simecek's NPI number?

The NPI number for Scott Simecek is 1104865765. It was assigned to this individual provider in the NPPES registry on June 6, 2006.

Where is Scott Simecek located?

Scott Simecek practices at 5701 Bow Pointe Dr Ste 365, Clarkston, MI 48346. The listed phone number is (248) 922-9283.

What is Scott Simecek's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Scott Simecek enrolled in Medicare?

Yes. Scott Simecek 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 Scott Simecek accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Scott Simecek 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 Scott Simecek affiliated with any hospitals?

According to CMS data, Scott Simecek is affiliated with Ascension Providence Hospital, Southfield And Novi, Trinity Health Oakland Hospital, Mclaren Oakland and Huron Valley-Sinai Hospital.

When was this NPI record last updated?

The NPPES record for Scott Simecek was last updated on February 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.