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DR. SIMON ROBERT COFRANCESCO D.O.
NPI 1396795241
Internal Medicine - Gastroenterology in Cumming, GA

Active since May 11, 2006PECOS EnrolledAccepts Medicare Assignment
80.89/100
CMS Quality Rating
4150 DEPUTY BILL CANTRELL MEMORIAL RD, SUITE 290, CUMMING, GA 30040(404) 446-0600(404) 446-0601 Get Directions Write a Review

NPPES record last updated: October 16, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 16, 2023, Sep 8, 2023, Oct 10, 2018 (3 updates tracked since 2018).

About Dr. Simon Robert Cofrancesco D.o. NPPES

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

DR. SIMON ROBERT COFRANCESCO D.O. (NPI 1396795241) is an individual gastroenterology provider in Cumming, Georgia, licensed in Georgia (62826) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Des Moines University Of Osteopathic Medicine And Health Sciences (1989).

NPPES Registry Identity

NPI1396795241
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. SIMON ROBERT COFRANCESCOCredential: D.O.
Location Address4150 DEPUTY BILL CANTRELL MEMORIAL RD, SUITE 290Cumming, GA 30040-3005
Mailing Address4150 Deputy Bill Cantrell Memorial Rd, Suite 290Cumming, GA 30040-3005 · (404) 446-0600 · Fax (404) 446-0601
Phone(404) 446-0600
Fax(404) 446-0601
Sole ProprietorNo
Medical School CMSDes Moines University Of Osteopathic Medicine And Health SciencesGraduated 1989
Enumeration DateMay 11, 2006
Last NPPES UpdateOctober 16, 20233 updates tracked since enumeration
NPPES CertifiedOctober 16, 2023
✔ NPI 1396795241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses✔ Licensed in GA · 62826✔ Licensed in MS · 13873
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.

4150 DEPUTY BILL CANTRELL MEMORIAL RD, Cumming, GA 30040
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

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. Simon Robert Cofrancesco D.o. 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 ID5799788220
PECOS Enrollment IDI20110926000075
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.

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.
287 services226 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.
113 services112 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.
111 services111 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.
107 services107 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.
107 services107 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.
92 services83 patients

Hospital Affiliations CMS Care Compare 3

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110005
Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County
Birthing friendly

Northside Hospital Cherokee

Acute Care Hospitals · Canton, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110008
Location450 Northside Cherokee BoulevardCanton, GA 30115 · Cherokee County
Emergency services Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30040 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

80.89/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality94.86
Improvement Activities40
Cost43.15

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
44%611 patients2/55-star benchmark: 99%
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%1,257 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.
71%1,048 patients3/55-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.
99%687 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.
3%603 patients1/55-star benchmark: 100%
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…
98%957 patients4/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
83%236 patients4/55-star benchmark: 100%
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…
100%603 patients5/55-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…
1%603 patients1/55-star benchmark: 79%
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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
1 supplier23 claims690 services$2.63 avg. paid by Medicare
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150
Other-Enteral and Parenteral · category OB006N
1 supplier22 claims9,921 services$0.32 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. HIRAL N PATEL RPA-C
Physician Assistant (Medical)
4150 DEPUTY BILL CANTRELL MEMORIAL RD, SUITE 260
CUMMING, GA 30040
Forsyth County (770) 292-3045
DR. TYLER INCHUL AN D.O.
Internal Medicine (Gastroenterology)
4150 DEPUTY BILL CANTRELL MEMORIAL RD, SUITE 290
CUMMING, GA 30040
Forsyth County (404) 446-0600
NEWCO GI LLC
Internal Medicine (Gastroenterology)
4150 DEPUTY BILL CANTRELL MEMORIAL RD, SUITE 290
CUMMING, GA 30040
Forsyth County (404) 446-0600
ERIN EILEEN YARD APRN FNP-C
Nurse Practitioner (Family)
4150 DEPUTY BILL CANTRELL MEMORIAL RD
CUMMING, GA 30040
Forsyth County (404) 446-0600
LAURA ANN WYNN BS
Behavior Technician
4150 DEPUTY BILL CANTRELL MEMORIAL RD, SUITE T200
CUMMING, GA 30040
Forsyth County (470) 839-3041
LAURA M GENONE AUD
Audiologist
4150 DEPUTY BILL CANTRELL MEMORIAL RD, SUITE 260
CUMMING, GA 30040
Forsyth County (770) 292-3045
DR. JOSEPH ANTHONY SCIARRINO M.D.
Otolaryngology
4150 DEPUTY BILL CANTRELL MEMORIAL RD, SUITE 260
CUMMING, GA 30040
Forsyth County (770) 292-3045
DR. MARK B VANDEUSEN M.D.
Otolaryngology
4150 DEPUTY BILL CANTRELL MEMORIAL RD, SUITE 260
CUMMING, GA 30040
Forsyth County (770) 292-3045

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 Simon Cofrancesco's NPI number?

The NPI number for Simon Cofrancesco is 1396795241. It was assigned to this individual provider in the NPPES registry on May 11, 2006.

Where is Simon Cofrancesco located?

Simon Cofrancesco practices at 4150 Deputy Bill Cantrell Memorial Rd Suite 290, Cumming, GA 30040. The listed phone number is (404) 446-0600.

What is Simon Cofrancesco's specialty?

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

Is Simon Cofrancesco enrolled in Medicare?

Yes. Simon Cofrancesco 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.

What insurance does Simon Cofrancesco accept?

Health plans from Alliant Health Plans, Inc. list Simon Cofrancesco as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Simon Cofrancesco affiliated with any hospitals?

According to CMS data, Simon Cofrancesco is affiliated with Northside Hospital Forsyth, Northside Hospital Cherokee and Northside Hospital.

When was this NPI record last updated?

The NPPES record for Simon Cofrancesco was last updated on October 16, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.