DR. MARC ALAN SIMON MD
NPI 1346215449
Internal Medicine - Advanced Heart Failure and Transplant Cardiology in San Francisco, CA

Q: What is Marc Simon's NPI number?

The NPI number for Marc Simon is 1346215449. It was assigned to this individual provider in the NPPES registry on February 22, 2006.

Q: What is Marc Simon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Advanced Heart Failure and Transplant Cardiology, with taxonomy code 207RA0001X.

Q: When was this NPI record last updated?

The NPPES record for Marc Simon was last updated on October 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since February 22, 2006PECOS EnrolledAccepts Medicare Assignment

74.46/100

CMS Quality Rating

535 MISSION BAY BLVD S, SAN FRANCISCO, CA 94143(415) 353-3109(415) 353-2528 Get Directions Write a Review

NPPES record last updated: October 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 14, 2021, Oct 1, 2021, Jul 20, 2020 (3 updates tracked since 2020).

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About Dr. Marc Alan Simon Md NPPES

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

DR. MARC ALAN SIMON MD (NPI 1346215449) is an individual advanced heart failure and transplant cardiology provider in San Francisco, California, licensed in California (C171930) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Maryland School Of Medicine (1998).

NPPES Registry Identity

NPI1346215449

Entity TypeIndividualMale

Primary Taxonomy207RA0001X

Provider Legal NameDR. MARC ALAN SIMONCredential: MD

Location Address535 MISSION BAY BLVD SSan Francisco, CA 94143-2156

Mailing Address535 Mission Blvd, SouthSan Francisco, CA 94143 · (415) 353-3109 · Fax (415) 353-2528

Phone(415) 353-3109

Fax(415) 353-2528

Sole ProprietorNo

Medical School CMSUniversity Of Maryland School Of MedicineGraduated 1998

Enumeration DateFebruary 22, 2006

Last NPPES UpdateOctober 14, 20213 updates tracked since enumeration

NPPES CertifiedOctober 14, 2021

✔ NPI 1346215449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Advanced Heart Failure and Transplant CardiologyAllopathic & Osteopathic Physicians

Taxonomy Code207RA0001X

Licenses✔ Licensed in CA · C171930✔ Licensed in PA · MD420221

Definition

Specialists in Advanced Heart Failure and Transplant Cardiology would participate in the inpatient and outpatient management of patients with advanced heart failure across the spectrum from consideration for high-risk cardiac surgery, cardiac transplantation, or mechanical circulatory support, to pre-and post-operative evaluation and management of patients with cardiac transplants and mechanical support devices, and end-of-life care for patients with end-stage heart failure.

Also ListedSpecialistTaxonomy 174400000X · License MD420221 (PA)

Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License MD420221 (PA), C171930 (CA)

535 MISSION BAY BLVD S, San Francisco, CA 94143

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Other Identifiers 1

Medicaid101298130PA

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. Marc Alan Simon 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 ID7810933611

PECOS Enrollment IDI20210324002562

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 5

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

116 services35 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

98 services72 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.

37 services29 patients

Evaluation of lower heart chamber assist device 93750

An evaluation of a lower heart chamber assist device is a procedure to check the function of an implanted device aiding your heart's lower chambers. This helps ensure optimal heart function by monitoring the device's performance and your heart's response to it.

36 services11 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94143 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

$153.83 typical visit price

range $69.00 – $202.35

Typical copayment $38.45 (range $17.25 – $50.58)

Most-billed visit code 99204

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

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.

74.46/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

Cost

46.68

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221

DME-Other DME · category DE017N

2 suppliers23 claims86 services$18.21 avg. paid by Medicare

Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222

DME-Medical/Surgical Supplies · category DA000N

2 suppliers20 claims538 services$34.63 avg. paid by Medicare

Injection, epoprostenol, 0.5 mg J1325

Treatment-Injections and Infusions (nononcologic) · category RI026N

1 supplier17 claims3,600 services$12.82 avg. paid by Medicare

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

5 suppliers16 claims1,710 services$0.28 avg. paid by Medicare

Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol) K0455

DME-Other DME · category DE000N

2 suppliers22 claims22 services$247.48 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

4 suppliers13 claims13 services$18.88 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MRS. LARA KRISA HOYLE ELGIN FNP-BC, MPH

Nurse Practitioner (Family)