1. Home
  2. Directory
  3. Florida
  4. Atlantis
  5. Internal Medicine
  6. NPI Profile

TODD SIMON DO
NPI 1225073489
Internal Medicine - Gastroenterology in Atlantis, FL

Active since June 19, 2006PECOS EnrolledAccepts Medicare Assignment
5401 S CONGRESS AVE STE 211, ATLANTIS, FL 33462(561) 964-8221(561) 964-7393 Get Directions Write a Review

NPPES record last updated: January 14, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 14, 2021, Sep 24, 2019 (2 updates tracked since 2019).

About Todd Simon Do NPPES

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

TODD SIMON DO (NPI 1225073489) is an individual gastroenterology provider in Atlantis, Florida, licensed in Florida (OS6993) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Hca Florida Jfk Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1225073489
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameTODD SIMONCredential: DO
Location Address5401 S CONGRESS AVE STE 211Atlantis, FL 33462-6637
Mailing Address5401 S Congress Ave Ste 211Atlantis, FL 33462-6637 · (561) 964-8221 · Fax (561) 964-7393
Phone(561) 964-8221
Fax(561) 964-7393
Sole ProprietorNo
Medical School CMSDes Moines University Of Osteopathic Medicine And Health SciencesGraduated 1990
Enumeration DateJune 19, 2006
Last NPPES UpdateJanuary 14, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 14, 2021
✔ NPI 1225073489 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in FL · OS6993
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
5401 S CONGRESS AVE STE 211, Atlantis, FL 33462
Open in Google Maps ↗

Secondary Practice Locations 2

Location 110115 Forest Hill Blvd Ste 200Wellington, FL 33414-3104 · Phone (561) 964-8221 · Fax (561) 964-7393
Location 2500 University Blvd Ste 116Jupiter, FL 33458-2774 · Phone (561) 964-8221 · Fax (561) 964-7393

Other Identifiers 1

Medicaid268898100FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) 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

Todd Simon Do 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 ID7810085818
PECOS Enrollment IDI20100420000837
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 9

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 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.
211 services155 patients
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.
182 services135 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.
161 services161 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
67 services67 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
64 services63 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
49 services49 patients

Hospital Affiliations CMS Care Compare 2

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

Hca Florida Jfk Hospital

Acute Care Hospitals · Atlantis, FL
2/5 CMS rating
OwnershipProprietary
CMS Certification Number100080
Location5301 S Congress AveAtlantis, FL 33462 · Palm Beach County
Emergency services

Wellington Regional Medical Center

Acute Care Hospitals · Wellington, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100275
Location10101 Forest Hill BlvdWellington, FL 33414 · Palm Beach County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33462 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
$135.56 typical visit price
range $58.56 – $179.05
Typical copayment $33.89 (range $14.64 – $44.76)
Most-billed visit code 99204
Established Patient
$103.21 typical visit price
range $18.44 – $144.68
Typical copayment $25.80 (range $4.61 – $36.17)
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

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
20%268 patients1/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
81%582 patients4/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
16%44 patients1/55-star benchmark: 100%
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.
98%1,581 patients4/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
22%561 patients1/55-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…
13%818 patients1/55-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%473 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.
19%1,243 patients1/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
27%561 patients2/55-star benchmark: 90%
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…
35%1,046 patients2/55-star benchmark: 97%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
10%913 patients1/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 273 patients
93%274 patients4/55-star benchmark: 98%
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…
100%1,243 patients5/55-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…
10%1,243 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.
33%1,243 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.

Other Providers at the Same Location NPPES 7

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

GI ALLIANCE ANESTHESIA OF FLORIDA, PLLC
Nurse Anesthetist, Certified Registered
5401 S CONGRESS AVE STE 211
ATLANTIS, FL 33462
Palm Beach County (561) 964-8221
NICOLE D MONROIG ARNP
Nurse Practitioner (Family)
5401 S CONGRESS AVE STE 211
ATLANTIS, FL 33462
Palm Beach County (561) 964-8221
LISBETH SOLER DE MARCO PA-C
Physician Assistant
5401 S CONGRESS AVE STE 211
LAKE WORTH, FL 33462
Palm Beach County (561) 335-5444
FREDERICK STUART SHERMAN MD
Internal Medicine (Gastroenterology)
5401 S CONGRESS AVE STE 211
ATLANTIS, FL 33462
Palm Beach County (561) 964-8221
AUGUSTO LOPEZ-TORRES MD
Internal Medicine (Gastroenterology)
5401 S CONGRESS AVE STE 211
ATLANTIS, FL 33462
Palm Beach County (561) 964-8221
GASTROENTEROLOGY ASSOCIATES OF FLORIDA LLC
Internal Medicine (Gastroenterology)
5401 S CONGRESS AVE STE 211
ATLANTIS, FL 33462
Palm Beach County (561) 964-8221
EUGENE FRANCO STOLOW MD, MPH
Internal Medicine (Gastroenterology)
5401 S CONGRESS AVE STE 211
ATLANTIS, FL 33462
Palm Beach County (561) 964-8221

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 Todd Simon's NPI number?

The NPI number for Todd Simon is 1225073489. It was assigned to this individual provider in the NPPES registry on June 19, 2006.

Where is Todd Simon located?

Todd Simon practices at 5401 S Congress Ave Ste 211, Atlantis, FL 33462. The listed phone number is (561) 964-8221.

What is Todd Simon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Todd Simon enrolled in Medicare?

Yes. Todd Simon 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 Todd Simon accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Oscar Health Maintenance Organization of Florida list Todd Simon 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 Todd Simon affiliated with any hospitals?

According to CMS data, Todd Simon is affiliated with Hca Florida Jfk Hospital and Wellington Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Todd Simon was last updated on January 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.