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DR. MATTHEW EDWARD SIMMONS M.D.
NPI 1396942223
Internal Medicine - Infectious Disease in Cumberland, MD

Active since July 03, 2007PECOS EnrolledAccepts Medicare Assignment
86.92/100
CMS Quality Rating
12502 WILLOWBROOK RD STE 400, CUMBERLAND, MD 21502(240) 964-8913(240) 964-8911 Get Directions Write a Review

NPPES record last updated: July 19, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 19, 2021, Jan 27, 2021, Jan 7, 2021 and 1 more (4 updates tracked since 2017).

About Dr. Matthew Edward Simmons M.d. NPPES

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

DR. MATTHEW EDWARD SIMMONS M.D. (NPI 1396942223) is an individual infectious disease provider in Cumberland, Maryland, licensed in Maryland (D90498) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Western Maryland Regional Medical Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1396942223
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameDR. MATTHEW EDWARD SIMMONSCredential: M.D.
Location Address12502 WILLOWBROOK RD STE 400Cumberland, MD 21502-6567
Mailing AddressPo Box 1671Cumberland, MD 21501-1671
Phone(240) 964-8913
Fax(240) 964-8911
Sole ProprietorNo
Medical School CMSWest Virginia University School Of MedicineGraduated 2011
Enumeration DateJuly 3, 2007
Last NPPES UpdateJuly 19, 20214 updates tracked since enumeration
NPPES CertifiedJuly 19, 2021
✔ NPI 1396942223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
Licenses✔ Licensed in MD · D90498✔ Licensed in WV · 23140
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
Also ListedInternal MedicineTaxonomy 207R00000X · License 23140 (WV)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
12502 WILLOWBROOK RD STE 400, Cumberland, MD 21502
Open in Google Maps ↗

Secondary Practice Locations 3

Location 12000 Professional Ct, Suite AMartinsburg, WV 25401-8803 · Phone (304) 264-9837 · Fax (304) 264-9838
Location 212500 Willowbrook RdCumberland, MD 21502-6393 · Phone (240) 964-8913 · Fax (240) 964-8911
Location 323789 Garrett HwyMc Henry, MD 21541-1338 · Phone (240) 488-4139 · Fax (240) 488-4956

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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. Matthew Edward Simmons 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 ID7315116142
PECOS Enrollment IDI20210201001171
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.

Hospital Affiliations CMS Care Compare

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

Western Maryland Regional Medical Center

Acute Care Hospitals · Cumberland, MD
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210027
Location12500 Willowbrook RoadCumberland, MD 21502 · Allegany County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21502 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
$133.05 typical visit price
range $57.99 – $175.57
Typical copayment $33.26 (range $14.49 – $43.89)
Most-billed visit code 99204
Established Patient
$102.11 typical visit price
range $18.66 – $143.02
Typical copayment $25.52 (range $4.66 – $35.75)
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.

86.92/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.08
Promoting Interoperability100
Improvement Activities40
Cost80.8

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEY NICOLE CHUCCI CRNP
Nurse Practitioner
12502 WILLOWBROOK RD STE 400
CUMBERLAND, MD 21502
Allegany County (240) 964-8910
DR. NEEHARIK MAREEDU MD
Internal Medicine (Nephrology)
12502 WILLOWBROOK RD STE 400
CUMBERLAND, MD 21502
Allegany County (240) 964-8910
STANLEY J MATYASIK DO PC
Internal Medicine (Pulmonary Disease)
12502 WILLOWBROOK RD STE 400
CUMBERLAND, MD 21502
Allegany County (240) 964-8640
RACHEL MEREDITH LAMBRIGHT
Physician Assistant
12502 WILLOWBROOK RD STE 400
CUMBERLAND, MD 21502
Allegany County (240) 964-8717

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 Matthew Simmons's NPI number?

The NPI number for Matthew Simmons is 1396942223. It was assigned to this individual provider in the NPPES registry on July 3, 2007.

Where is Matthew Simmons located?

Matthew Simmons practices at 12502 Willowbrook Rd Ste 400, Cumberland, MD 21502. The listed phone number is (240) 964-8913.

What is Matthew Simmons's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Matthew Simmons enrolled in Medicare?

Yes. Matthew Simmons 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 Matthew Simmons accept?

Health plans from CareSource list Matthew Simmons 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 Matthew Simmons affiliated with any hospitals?

According to CMS data, Matthew Simmons is affiliated with Western Maryland Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Matthew Simmons was last updated on July 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.