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HILLARY LYNN SIMON
NPI 1245694173
Surgery in Louisville, KY

Active since April 06, 2016PECOS EnrolledAccepts Medicare Assignment
73.19/100
CMS Quality Rating
401 E CHESTNUT ST UNIT 710, LOUISVILLE, KY 40202(502) 583-8303 Get Directions Write a Review

NPPES record last updated: May 23, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 23, 2023, Jul 16, 2022 (2 updates tracked since 2022).

About Hillary Lynn Simon NPPES

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

HILLARY LYNN SIMON (NPI 1245694173) is an individual surgery provider in Louisville, Kentucky, licensed in Kentucky (05238) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, is affiliated with Jewish Hospital & St Mary's Healthcare, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1245694173
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameHILLARY LYNN SIMON
Location Address401 E CHESTNUT ST UNIT 710Louisville, KY 40202-5707
Mailing AddressPo Box 909Louisville, KY 40201-0909 · (502) 588-0325
Phone(502) 583-8303
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 6, 2016
Last NPPES UpdateMay 23, 20232 updates tracked since enumeration
NPPES CertifiedMay 23, 2023
✔ NPI 1245694173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in KY · 05238
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 ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
401 E CHESTNUT ST UNIT 710, Louisville, KY 40202
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health 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

Hillary Lynn Simon 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 ID6103114517
PECOS Enrollment IDI20230807002018
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 3

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.
26 services26 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.
17 services11 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

Hospital Affiliations CMS Care Compare 3

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

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180040
Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County
Emergency services

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180088
Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County
Emergency services Birthing friendly

University Of Louisville Hospital

Acute Care Hospitals · Louisville, KY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180141
Location530 South Jackson StreetLouisville, KY 40202 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40202 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
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.

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.

73.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality58.74
Promoting Interoperability100
Improvement Activities40
Cost51.91

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.

AMANDA JONES MSN, APRN, FNP-C
Nurse Practitioner
401 E CHESTNUT ST UNIT 710
LOUISVILLE, KY 40202
Jefferson County (502) 583-8303
NEAL BHUTIANI MD, PHD
Surgery (Surgical Oncology)
401 E CHESTNUT ST UNIT 710
LOUISVILLE, KY 40202
Jefferson County (502) 583-8303
NANCY S CLARK M.D.
Surgery (Vascular Surgery)
401 E CHESTNUT ST UNIT 710
LOUISVILLE, KY 40202
Jefferson County (502) 583-8303
UNIVERSITY OF LOUISVILLE PHYSICIANS, INC.
Surgery (Plastic and Reconstructive Surgery)
401 E CHESTNUT ST UNIT 710
LOUISVILLE, KY 40202
Jefferson County (502) 583-8303
MS. SANDRA L. KAVALUKAS M.D.
Colon & Rectal Surgery
401 E CHESTNUT ST UNIT 710
LOUISVILLE, KY 40202
Jefferson County (502) 583-8303
ASHLEY NICOLE HIGDON
Nurse Practitioner (Gerontology)
401 E CHESTNUT ST UNIT 710
LOUISVILLE, KY 40202
Jefferson County (502) 583-8303
MARY MARGARET ANN YATES APRN
Nurse Practitioner (Family)
401 E CHESTNUT ST UNIT 710
LOUISVILLE, KY 40202
Jefferson County (502) 583-8303
JOANNE MISSI
Nurse Practitioner (Family)
401 E CHESTNUT ST UNIT 710
LOUISVILLE, KY 40202
Jefferson County (502) 583-8303

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 Hillary Simon's NPI number?

The NPI number for Hillary Simon is 1245694173. It was assigned to this individual provider in the NPPES registry on April 6, 2016.

Where is Hillary Simon located?

Hillary Simon practices at 401 E Chestnut St Unit 710, Louisville, KY 40202. The listed phone number is (502) 583-8303.

What is Hillary Simon's specialty?

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

Is Hillary Simon enrolled in Medicare?

Yes. Hillary 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 Hillary Simon accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield and 1 other insurer list Hillary 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 Hillary Simon affiliated with any hospitals?

According to CMS data, Hillary Simon is affiliated with Jewish Hospital & St Mary's Healthcare, Norton Hospitals, Inc and University Of Louisville Hospital.

When was this NPI record last updated?

The NPPES record for Hillary Simon was last updated on May 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.