Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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: September 16, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 16, 2026, Jul 19, 2021, Jan 27, 2021 and 2 more (5 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 Garrett 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
Fax(240) 964-8911
Sole ProprietorNo
Medical School CMSWest Virginia University School Of MedicineGraduated 2011
Enumeration DateJuly 3, 2007
Last NPPES UpdateSeptember 16, 20265 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)
12502 WILLOWBROOK RD STE 400, Cumberland, MD 21502

Secondary Practice Locations 3

Location 112500 Willowbrook RdCumberland, MD 21502-6393 · Phone (240) 964-8913 · Fax (240) 964-8911
Location 223789 Garrett HwyMc Henry, MD 21541-1338 · Phone (240) 488-4139 · Fax (240) 488-4956
Location 32000 Professional Ct, Suite AMartinsburg, WV 25401-8803 · Phone (304) 264-9837 · Fax (304) 264-9838

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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 IDI20110811000262, I20210201001171
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.

Medicare Billing Reassignments

4

Medicare enrollment records show Matthew Simmons reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Psychiatry
12502 WILLOWBROOK RD, SUITE 380
Cumberland, MD 21502
  • Reassigned Medicare billing, Maryland enrollment
  • 210 clinicians in this Medicare group
Internal Medicine
12502 WILLOWBROOK RD
Cumberland, MD 21502
  • Reassigned Medicare billing, Maryland enrollment
  • 318 clinicians in this Medicare group
Internal Medicine
566 S MINERAL ST
Keyser, WV 26726
  • Reassigned Medicare billing, West Virginia enrollment
  • Medicare enrollment name: Potomac Valley Hospital Of W Va, Inc
  • Also billed through NPI 1912979873 (West Virginia)
  • 147 clinicians in this Medicare group
Mental Health (Including Community Mental Health Center)
32 CORPORATE DR
Grantsville, MD 21536
  • Reassigned Medicare billing, Maryland enrollment
  • 120 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 3

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

Garrett Regional Medical Center

Acute Care Hospitals · Oakland, MD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210017
Location251 North Fourth StreetOakland, MD 21550 · Garrett County
Emergency services Birthing friendly

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

Potomac Valley Hospital

Critical Access Hospitals · Keyser, WV
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number511315
Location100 Pin Oak LaneKeyser, WV 26726 · Mineral County
Emergency services

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.

Nurse Practitioner
12502 WILLOWBROOK RD STE 400
CUMBERLAND, MD 21502
Internal Medicine (Nephrology)
12502 WILLOWBROOK RD STE 400
CUMBERLAND, MD 21502
Internal Medicine (Pulmonary Disease)
12502 WILLOWBROOK RD STE 400
CUMBERLAND, MD 21502
Physician Assistant
12502 WILLOWBROOK RD STE 400
CUMBERLAND, MD 21502

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.

Which organizations bill Medicare for Matthew Simmons's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Simmons reassigns Medicare benefits to 4 organizations: Upmc Western Maryland Corporation (Cumberland, MD), Upmc Western Maryland Health Services, LLC (Cumberland, MD), Potomac Valley Hospital Of Wv, Inc. (Keyser, WV) and Specialty Physicians Of Garrett County, LLC (Grantsville, MD). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Matthew Simmons's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Matthew Simmons accept?

Health plans from CareSource, Highmark Blue Cross Blue Shield West Virginia and Molina Healthcare 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 Garrett Regional Medical Center, Western Maryland Regional Medical Center and Potomac Valley Hospital.

When was this NPI record last updated?

The NPPES record for Matthew Simmons was last updated on September 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days 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.