KARL ANTHONY SIMON P.A.
NPI 1356671630
Physician Assistant in Dalhart, TX

NPI Status: Active since January 08, 2010

Contact Information

1411 DENVER AVE
DALHART, TX
ZIP 79022
Phone: (806) 244-9267

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  • Individual
  • Male
  • Years of Experience 15
  • Physician Assistant
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About KARL SIMON

Karl Simon is a primary care provider established in Dalhart, Texas and his medical specialization is Physician Assistant with more than 15 years of experience. The healthcare provider is registered in the NPI registry with number 1356671630 assigned on January 2010. The practitioner's primary taxonomy code is 363A00000X with license number PA06580 (TX). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI1356671630
Provider NameKARL ANTHONY SIMON P.A.
Location Address1411 DENVER AVE DALHART, TX 79022
Location Phone(806) 244-9267
Mailing Address7415 BROKEN OAK LANE SUGAR LAND, TX 77479
GenderMale
Entity TypeIndividual
Medical School NameOTHER
Graduation Year2009
Is Sole Proprietor?Yes
Enumeration Date01-08-2010
Last Update Date07-30-2021
Code Navigator

A primary care provider (PCP) like Karl Simon sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Karl Simon 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.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.84 for a new patient copayment and $17.81 for an established patient copayment.

Location Map

Mailing Address

7415 BROKEN OAK LANE
SUGAR LAND, TX
ZIP 77479
Phone: (832) 265-7883

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

Physician Assistant

Taxonomy Code363A00000X
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.PA06580
License StateTX
Taxonomy DescriptionA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363A00000XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant

1088804 (TX)

PECOS Enrollment and Medicare Participation Status

Karl Simon 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

  • PECOS PAC ID: 9335263664

    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: I20100824000391

    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): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician 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 79022 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $87.36
  • Minimum New Patient Price $56.75
  • Maximum New Patient Price $172.6
  • Average New Patient Copayment $21.84
  • Minimum New Patient Copayment $14.18
  • Maximum New Patient Copayment $43.15

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $71.24
  • Minimum Established Patient Price $17.72
  • Maximum Established Patient Price $141.29
  • Average Established Patient Copayment $17.81
  • Minimum Established Patient Copayment $4.43
  • Maximum Established Patient Copayment $35.32

* 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.

Reviews for KARL ANTHONY SIMON P.A.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1356671630
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
23106127266
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 0 + 6 + 1 + 2 + 7 + 2 + 6 + 6 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1356671630 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 19 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1457474660MRS. KATHY M KELSO M.S. CCC-SLP
Individual
Speech-Language Pathologist1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571
1265766133 TANYA SMITH P.T.A
Individual
Physical Therapy Assistant1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571
1942610514 KATY ANN SAWYER PTA
Individual
Physical Therapy Assistant1411 DENVER AVE
DALHART, TX 79022
(806) 244-0015
1629478466DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Organization
Pharmacy (Institutional Pharmacy)1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571
1629248943DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Organization
Durable Medical Equipment & Medical Supplies1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571
1164900999 BIANCA CRYSTAL RETANA COTA
Individual
Occupational Therapy Assistant1411 DENVER AVE
DALHART, TX 79022
(806) 244-0016
1609341338 BARBARA ELAINE LEDBETTER
Individual
Registered Nurse (Registered Nurse First Assistant)1411 DENVER AVE
DALHART, TX 79022
(806) 244-9241
1124596499HCC OF DALHART LLC
Organization
Internal Medicine1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571
1154899425ESS OF DALHART LLC
Organization
Emergency Medicine1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571
1710445390 JONATHAN PAUL SOMMER
Individual
Physical Medicine & Rehabilitation1411 DENVER AVE
DALHART, TX 79022
(346) 305-9738
1649887308 AMBER DON DURAN LMSW
Individual
Social Worker1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571
1184631947 JASON MAYFIELD WRIGHT MPAS, PA-C
Individual
Physician Assistant (Medical)1411 DENVER AVE
DALHART, TX 79022
(806) 244-9251
1871956037 EUGENE TRAVIS STONE III MD
Individual
Emergency Medicine1411 DENVER AVE
DALHART, TX 79022
(832) 498-2040
1245353747DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Organization
General Acute Care Hospital (Critical Access)1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571
1336262831DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Organization
General Acute Care Hospital (Critical Access)1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571
1639176456DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Organization
General Acute Care Hospital (Critical Access)1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571
1871133561 LEAH BREEANN FORD APRN
Individual
Nurse Practitioner1411 DENVER AVE
DALHART, TX 79022
(512) 869-9298
1679289540 JENMARK ADAN CRUZ APRN
Individual
Nurse Practitioner (Family)1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571
1154029718MISS PUI CHUN LEE RD
Individual
Dietitian, Registered1411 DENVER AVE
DALHART, TX 79022
(806) 244-4571

Frequently Asked Questions

What is Karl Simon P.A. NPI number?

The NPI number assigned to this healthcare provider is 1356671630, enumerated in the NPI registry as an "individual" on January 08, 2010

Where is the provider located?

The provider is located at 1411 Denver Ave Dalhart, Tx 79022 and the phone number is (806) 244-9267

What is the provider specialty code?

The provider's speciality is Physician Assistant with taxonomy code 363A00000X

How many years of experience does Karl Simon P.A. have?

The provider has more than 15 years of experience.

Is Karl Simon P.A. registered in PECOS?

Yes, as of February 16, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

How much is a visit to Karl Simon P.A.?

Medicare beneficiaries should expect a typical cost of $87.36 with an average copayment of $21.84 for new patient appointments. Established patients should expect a typical charge of $71.24 and an average copayment of 17.81. Please review your insurance plan or contact the provider directly to determine your specific costs.

How do I update my NPI information?

This NPI record was last updated on January 08, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.