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DR. MICHAEL EVAN SIMONS MD
NPI 1265433015
Internal Medicine - Gastroenterology in Corbin, KY

Active since August 02, 2005PECOS EnrolledAccepts Medicare Assignment
1710 CUMBERLAND FALLS HWY, CORBIN, KY 40701(606) 528-6700(606) 528-6513 Get Directions Write a Review

NPPES record last updated: May 9, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 9, 2017, Jan 15, 2016 (2 updates tracked since 2016).

About Dr. Michael Evan Simons Md NPPES

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

DR. MICHAEL EVAN SIMONS MD (NPI 1265433015) is an individual gastroenterology provider in Corbin, Kentucky, licensed in Kentucky (25912) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Corbin, and is a graduate of University Of Louisville School Of Medicine (1987).

NPPES Registry Identity

NPI1265433015
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. MICHAEL EVAN SIMONSCredential: MD
Location Address1710 CUMBERLAND FALLS HWYCorbin, KY 40701-2727
Mailing Address1710 Cumberland Falls HwyCorbin, KY 40701-2727 · (606) 528-6700 · Fax (606) 528-6513
Phone(606) 528-6700
Fax(606) 528-6513
Sole ProprietorYes
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1987
Enumeration DateAugust 2, 2005
Last NPPES UpdateMay 9, 20172 updates tracked since enumeration
✔ NPI 1265433015 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 KY · 25912
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.
1710 CUMBERLAND FALLS HWY, Corbin, KY 40701
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Other Identifiers 3

Medicare PIN0575601KY
Medicare PIN100012500KY
Medicaid64259120KY

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. Michael Evan Simons Md 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 ID1759352164
PECOS Enrollment IDI20110301000603
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 12

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.

Telephone medical discussion with physician, 5-10 minutes 99441
A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.
111 services51 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.
97 services97 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
91 services91 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.
68 services68 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.
56 services47 patients
Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249
This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.
25 services19 patients

Hospital Affiliations CMS Care Compare

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

Baptist Health Corbin

Acute Care Hospitals · Corbin, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180080
LocationOne Trillium WayCorbin, KY 40701 · Whitley County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40701 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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
2%105 patients1/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
11%93 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
26%223 patients2/55-star benchmark: 85%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%368 patients5/55-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.
100%4,505 patients5/55-star benchmark: 100%
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.
95%3,236 patients4/55-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.
53%384 patients3/55-star benchmark: 99%
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…
100%101 patients5/55-star benchmark: 97%
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 tobacco: 100% · 222 patients
96%232 patients
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…
77%384 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…
12%384 patients1/55-star benchmark: 59%
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 3

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

CUMBERLAND GI, PSC
Internal Medicine (Gastroenterology)
1710 CUMBERLAND FALLS HWY
CORBIN, KY 40701
Whitley County (606) 528-6700
PRODIGY OFFICE ANESTHESIA, LLC
Nurse Anesthetist, Certified Registered
1710 CUMBERLAND FALLS HWY
CORBIN, KY 40701
Whitley County (606) 528-6700
JANICE HEDAYATI NP
Nurse Practitioner
1710 CUMBERLAND FALLS HWY
CORBIN, KY 40701
Whitley County (606) 528-6700

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 Michael Simons's NPI number?

The NPI number for Michael Simons is 1265433015. It was assigned to this individual provider in the NPPES registry on August 2, 2005.

Where is Michael Simons located?

Michael Simons practices at 1710 Cumberland Falls Hwy, Corbin, KY 40701. The listed phone number is (606) 528-6700.

What is Michael Simons's specialty?

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

Is Michael Simons enrolled in Medicare?

Yes. Michael Simons 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.

Is Michael Simons affiliated with any hospitals?

According to CMS data, Michael Simons is affiliated with Baptist Health Corbin.

When was this NPI record last updated?

The NPPES record for Michael Simons was last updated on May 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.