DR. MICHAEL SIMON M.D.
NPI 1366896912
Internal Medicine - Pulmonary Disease in Fall River, MA

Q: What is Michael Simon's NPI number?

The NPI number for Michael Simon is 1366896912. It was assigned to this individual provider in the NPPES registry on April 20, 2016.

Q: What is Michael Simon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Michael Simon was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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 April 20, 2016PECOS EnrolledAccepts Medicare Assignment

1030 PRESIDENT AVE STE 210, FALL RIVER, MA 02720(508) 973-1780(508) 973-7338 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 29, 2020, Apr 4, 2019, Feb 27, 2019 (3 updates tracked since 2019).

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About Dr. Michael Simon M.d. NPPES

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

DR. MICHAEL SIMON M.D. (NPI 1366896912) is an individual pulmonary disease provider in Fall River, Massachusetts, licensed in Massachusetts (291140) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Southcoast Hospitals Group, and is a graduate of George Washington University School Of Medicine (2016).

NPPES Registry Identity

NPI1366896912

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. MICHAEL SIMONCredential: M.D.

Location Address1030 PRESIDENT AVE STE 210Fall River, MA 02720-5928

Mailing Address593 Eddy StProvidence, RI 02903-4923 · (401) 444-8410 · Fax (401) 444-5914

Phone(508) 973-1780

Fax(508) 973-7338

Sole ProprietorYes

Medical School CMSGeorge Washington University School Of MedicineGraduated 2016

Enumeration DateApril 20, 2016

Last NPPES UpdateJanuary 22, 20253 updates tracked since enumeration

NPPES CertifiedJanuary 22, 2025

✔ NPI 1366896912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

Licenses✔ Licensed in MA · 291140✔ Licensed in RI · LP04894

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

1030 PRESIDENT AVE STE 210, Fall River, MA 02720

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Simon M.d. 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 ID9335482892

PECOS Enrollment IDI20220606000575

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 17

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.

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.

171 services132 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

143 services69 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.

102 services102 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.

85 services74 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

58 services58 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

57 services57 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

53 services53 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

53 services53 patients

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.

37 services26 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

29 services29 patients

Test to examine how well the lungs exchange gases 94729

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.

26 services17 patients

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.

18 services18 patients

Test to determine lung volumes using sensors 94726

14 services14 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

12 services12 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.

12 services12 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Southcoast Hospitals Group

Acute Care Hospitals · Fall River, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220074

Location363 Highland AvenueFall River, MA 02720 · Bristol County

Emergency services Birthing friendly

Newport Hospital

Acute Care Hospitals · Newport, RI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number410006

Location11 Friendship StreetNewport, RI 02840 · Newport County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02720 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

$134.47 typical visit price

range $58.86 – $177.36

Typical copayment $33.61 (range $14.71 – $44.34)

Most-billed visit code 99204

Established Patient

$103.48 typical visit price

range $19.11 – $144.84

Typical copayment $25.87 (range $4.77 – $36.21)

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.

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 Simon's NPI number?

The NPI number for Michael Simon is 1366896912. It was assigned to this individual provider in the NPPES registry on April 20, 2016.

Where is Michael Simon located?

Michael Simon practices at 1030 President Ave Ste 210, Fall River, MA 02720. The listed phone number is (508) 973-1780.

What is Michael Simon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Michael Simon enrolled in Medicare?

Yes. Michael 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.

Is Michael Simon affiliated with any hospitals?

According to CMS data, Michael Simon is affiliated with Southcoast Hospitals Group and Newport Hospital.

When was this NPI record last updated?

The NPPES record for Michael Simon was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.