RANDALL L SIMONSEN MD PA
NPI 1235261082
Pathology - Anatomic Pathology & Clinical Pathology in Kingsville, TX
NPI Status: Active since March 09, 2007
Contact Information
1311 GENERAL CAVAZOS BLVD
KINGSVILLE, TX
ZIP 78363
Phone: (361) 595-1661
- Individual
- Male
- Pathology
- Anatomic Pathology & Clinical Pathology
- Accepts Insurance
- PECOS Enrolled
About RANDALL SIMONSEN
This page provides the complete NPI Profile along with additional information for Randall Simonsen, a provider established in Kingsville, Texas with a medical specialization in Pathology, focusing in anatomic pathology & clinical pathology . The healthcare provider is registered in the NPI registry with number 1235261082 assigned on March 2007. The practitioner's primary taxonomy code is 207ZP0102X with license number H8840 (TX). The provider is registered as an individual and his NPI record was last updated 14 years ago.
- NPI
- 1235261082
- Provider Name
- RANDALL L SIMONSEN MD PA
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1311 GENERAL CAVAZOS BLVD KINGSVILLE, TX 78363
- Location Phone
- (361) 595-1661
- Mailing Address
- 15210 CARTAGENA CT CORPUS CHRISTI, TX 78418
- Mailing Phone
- (361) 779-8813
- Mailing Fax
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-09-2007
- Last Update Date
- 10-18-2012
- 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.
- H8840
- License State
- TX
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- CHRISTUS Bronze (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Bronze + Dental & Vision (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Bronze Essential - HMO
- CHRISTUS Bronze Essential (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Bronze Essential + Dental & Vision (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Bronze Essential Plus - HMO
- CHRISTUS Catastrophic (3 Free PCP visits) - HMO
- CHRISTUS Gold - HMO
- CHRISTUS Gold + Dental & Vision + Fitness ($0 Deductible, $5 PCP, $0 Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Gold + Fitness ($0 Deductible, $5 PCP, $0 Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Gold Essential - HMO
- CHRISTUS Gold Essential ($0 Rx Deductible, $5 PCP, $0 Virtual Urgent Care) - HMO
- CHRISTUS Gold Essential + Dental & Vision ($0 Rx Deductible, $5 PCP, $0 Virtual Urgent Care) - HMO
- CHRISTUS Gold Essential Plus - HMO
- CHRISTUS Gold Plus - HMO
- CHRISTUS Silver Essential - HMO
- CHRISTUS Silver Essential 70 ($5 PCP, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Silver Essential 70 + Dental & Vision ($5 PCP, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Silver Essential Plus - HMO
- CHRISTUS Standard Expanded Bronze - HMO
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 |
|---|---|---|---|
| E51605 | MEDICARE UPIN (02) | TX | |
| P000U07W0 | MEDICARE ID-TYPE UNSPECIFIED (04) | ||
| 00U07W | MEDICAID (05) | TX |
Medicare Participation & PECOS Enrollment Status
Randall Simonsen 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.
Pathology examination of tissue using a microscope, intermediate complexity
Pathology examination of tissue using a microscope, moderately low complexity
Special stained specimen slides to examine tissue including interpretation and report
Special stained specimen slides to identify organisms including interpretation and report
A 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 125 times for 72 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 35 times for 31 patientsSpecial stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.
This service was performed 55 times for 46 patientsThis service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.
This service was performed 56 times for 40 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 78363 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.4
- Minimum New Patient Price $54.84
- Maximum New Patient Price $166.88
- Average New Patient Copayment $31.6
- Minimum New Patient Copayment $13.71
- Maximum New Patient Copayment $41.72
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.05
- Minimum Established Patient Price $17.52
- Maximum Established Patient Price $136.11
- Average Established Patient Copayment $24.26
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.02
* 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 1235261082, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
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 58 is 60. 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.
KINGSVILLE, TX 78363
KINGSVILLE, TX 78363
KINGSVILLE, TX 78363
KINGSVILLE, TX 78363
KINGSVILLE, TX 78363
KINGSVILLE, TX 78363
KINGSVILLE, TX 78363
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1235261082, enumerated as an "individual" on March 09, 2007.
The provider is located at 1311 GENERAL CAVAZOS BLVD KINGSVILLE, TX 78363 and the phone number is (361) 595-1661.
Pathology with taxonomy code 207ZP0102X and a focus in Anatomic Pathology & Clinical Pathology.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, CHRISTUS. Please consult your insurance carrier or call the provider to verify.
