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SIMON K WU MD
NPI 1407044241
Family Medicine in Kankakee, IL

Active since October 05, 2007PECOS EnrolledAccepts Medicare AssignmentCLIA 14D0857949 · Waiver
400 N WALL ST STE 303, KANKAKEE, IL 60901(815) 933-1664(815) 935-5660 Get Directions Write a Review

NPPES record last updated: December 11, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 11, 2024, Jul 23, 2024, Sep 12, 2018 and 1 more (4 updates tracked since 2018).

About Simon K Wu Md NPPES

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

SIMON K WU MD (NPI 1407044241) is an individual family medicine provider in Kankakee, Illinois, licensed in Illinois (036089802) and active in the NPI registry since October 2007. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through June 17, 2028, and is affiliated with Presence St Marys Hospital.

NPPES Registry Identity

NPI1407044241
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameSIMON K WUCredential: MD
Location Address400 N WALL ST STE 303Kankakee, IL 60901-2964
Mailing Address400 N Wall St Ste 303Kankakee, IL 60901-2964 · (815) 933-1664 · Fax (815) 935-5660
Phone(815) 933-1664
Fax(815) 935-5660
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 1990
Enumeration DateOctober 5, 2007
Last NPPES UpdateDecember 11, 20244 updates tracked since enumeration
NPPES CertifiedDecember 11, 2024
✔ NPI 1407044241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036089802
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
400 N WALL ST STE 303, Kankakee, IL 60901
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Other Names 1

Former Name (1)Kwok Wai Wu Md

Other Identifiers 2

Medicaid036089802IL
Other04623007Bcbs Of Illinois

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

Simon K Wu Md 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 ID446301378
PECOS Enrollment IDI20090706000278
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0857949

Simon Wu MD Ltd · Kankakee, IL
Active · expires Jun 17, 2028
CLIA Number14D0857949
Laboratory TypePhysician Office
Certificate Effective DateJune 18, 2026
Certificate Expiration DateJune 17, 2028
Laboratory DirectorSimon K. Wu
Laboratory Phone(815) 933-1664
Laboratory LocationSimon Wu MD Ltd401 N Wall St Ste 303, Kankakee, IL 60901
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.
480 services133 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
379 services47 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.
136 services83 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
112 services112 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
90 services87 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
74 services64 patients

Hospital Affiliations CMS Care Compare 2

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

Presence St Marys Hospital

Acute Care Hospitals · Kankakee, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140155
Location500 W Court StKankakee, IL 60901 · Kankakee County
Emergency services Birthing friendly

Riverside Medical Center

Acute Care Hospitals · Kankakee, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140186
Location350 N Wall StKankakee, IL 60901 · Kankakee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60901 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

Reported Quality Measures

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.
78%1,397 patients3/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
2%208 patients1/55-star benchmark: 98%
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.
100%39 patients5/55-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.
34%603 patients2/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%144 patients5/55-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…
78%603 patients4/55-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…
79%603 patients5/55-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 12

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers36 claims61 services$5.82 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers21 claims21 services$0.81 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
1 supplier15 claims65 services$2.03 avg. paid by Medicare
Humidifier, heated, used with positive airway pressure device E0562
DME-Other DME · category DE001N
1 supplier15 claims15 services$15.00 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier13 claims13 services$6.24 avg. paid by Medicare
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605
DME-Drugs Administered Through DME · category DG006N
1 supplier16 claims960 services$4.44 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 3

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

DR. PHILIP G HAYS M.D
Internal Medicine (Cardiovascular Disease)
400 N WALL ST STE 303
KANKAKEE, IL 60901
Kankakee County (815) 935-8040
SIMON WU MD LTD
Family Medicine
400 N WALL ST STE 303
KANKAKEE, IL 60901
Kankakee County (815) 933-1664
PHILIP G HAYS MD SC
Internal Medicine (Cardiovascular Disease)
400 N WALL ST STE 303
KANKAKEE, IL 60901
Kankakee County (815) 935-8040

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 Wu's NPI number?

The NPI number for Simon Wu is 1407044241. It was assigned to this individual provider in the NPPES registry on October 5, 2007. The provider is also known as Kwok Wai Wu MD.

Where is Simon Wu located?

Simon Wu practices at 400 N Wall St Ste 303, Kankakee, IL 60901. The listed phone number is (815) 933-1664.

What is Simon Wu's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Simon Wu enrolled in Medicare?

Yes. Simon Wu 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.

Does Simon Wu hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0857949) is associated with this NPI, valid through June 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Simon Wu affiliated with any hospitals?

According to CMS data, Simon Wu is affiliated with Presence St Marys Hospital and Riverside Medical Center.

When was this NPI record last updated?

The NPPES record for Simon Wu was last updated on December 11, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.