ROBERTA JO SIMONS
NPI 1275245367
Counselor - Professional in Bridgeport, WV

NPI Status: Active since December 20, 2022

Contact Information

65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV
ZIP 26330
Phone: (304) 848-5770

Get Directions Write a Review

  • Individual
  • Female
  • Years of Experience 21
  • Counselor
  • Professional
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ROBERTA SIMONS

This page provides the complete NPI Profile along with additional information for Roberta Simons, a provider established in Bridgeport, West Virginia with a medical specialization in Counselor, focusing in professional and more than 21 years of experience. The healthcare provider is registered in the NPI registry with number 1275245367 assigned on December 2022. The practitioner's primary taxonomy code is 101YP2500X with license number 2693 (WV). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI
1275245367
Provider Name
ROBERTA JO SIMONS
Gender
Female
Entity Type
Individual
Location Address
65 PROFESSIONAL PL STE 102103 BRIDGEPORT, WV 26330
Location Phone
(304) 848-5770
Mailing Address
65 PROFESSIONAL PL STE 102103 BRIDGEPORT, WV 26330
Mailing Phone
(304) 848-5770
Medical School Name
OTHER
Graduation Year
2005
Is Sole Proprietor?
No
Enumeration Date
12-20-2022
Last Update Date
12-20-2022
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

Counselor Professional

Taxonomy Code
101YP2500X
Type
Behavioral Health & Social Service Providers
License No.
2693
License State
WV

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Low Deductible Silver 5000 $3 Generic Drugs - HMO
  • Low Deductible Silver 5000 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Platinum Zero $5 Generic Drugs - HMO
  • Platinum Zero $5 Generic Drugs + Adult Vision & Fitness - HMO
  • my Blue Access WV Major Events PPO Catastrophic 10600 - 3 Free PCP Visits - PPO
  • my Blue Access WV PPO Bronze 3800 - PPO
  • my Blue Access WV PPO Bronze 3800 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Bronze 9200 - PPO
  • my Blue Access WV PPO Gold 0 - PPO
  • my Blue Access WV PPO Gold 0 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Gold 1700 HSA - PPO
  • my Blue Access WV PPO Premier Gold 0 - PPO
  • my Blue Access WV PPO Premier Gold 0 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Premier Silver 0 - PPO
  • my Blue Access WV PPO Premier Silver 0 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Standard Bronze 7500 - PPO
  • my Blue Access WV PPO Standard Gold 2000 - PPO
  • my Blue Access WV PPO Standard Gold 2000 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Standard Silver 6000 - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Roberta Simons is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Roberta Simons 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 and Durable Medical Equipment (DME).

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

  • PECOS PAC ID: 2264883388

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20240112001407

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • 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): No

  • Eligible to Order or Refer Power Mobility Devices: No

Reviews for ROBERTA JO SIMONS

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

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 1275245367, we treat the final digit (7) 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

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.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
5
Unchanged
Pos 5
2
Doubled → 4
Pos 6
4
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
3
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
7
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 7 → 14 → 5 2 → 4 5 → 10 → 1 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 4 + 5 + 4 + 4 + 1 + 0 + 3 + 1 + 2 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1275245367.

Other Providers at the Same Location


The following 16 providers are registered at the same or a nearby location.

Clinic/Center (Federally Qualified Health Center (FQHC))
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Social Worker (Clinical)
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Family Medicine
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Psychologist
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Social Worker (Clinical)
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Social Worker (Clinical)
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Social Worker
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Social Worker
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Social Worker (Clinical)
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Psychiatry & Neurology (Psychiatry)
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Case Manager/Care Coordinator
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Peer Specialist
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Nurse Practitioner (Psychiatric/Mental Health)
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Behavior Analyst
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Counselor (Professional)
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330
Counselor (Professional)
65 PROFESSIONAL PL STE 102103
BRIDGEPORT, WV 26330

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275245367, enumerated as an "individual" on December 20, 2022.

The provider is located at 65 PROFESSIONAL PL STE 102103 BRIDGEPORT, WV 26330 and the phone number is (304) 848-5770.

Counselor with taxonomy code 101YP2500X and a focus in Professional.

The provider might be accepting Accepts: CareSource and Highmark Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.