DR. CARMEN SYLVIA SIMMONS MD
NPI 1417534553
Family Medicine in Stone Mountain, GA

Q: What is Carmen Simmons's NPI number?

The NPI number for Carmen Simmons is 1417534553. It was assigned to this individual provider in the NPPES registry on March 25, 2021.

Q: What is Carmen Simmons's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Carmen Simmons was last updated on July 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since March 25, 2021PECOS Enrolled

PO BOX 870589, STONE MOUNTAIN, GA 30087(678) 464-1312 Get Directions Write a Review

NPPES record last updated: July 16, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 16, 2024, Jun 26, 2024, Mar 25, 2021 (3 updates tracked since 2021).

On this page

About Dr. Carmen Sylvia Simmons Md NPPES

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

DR. CARMEN SYLVIA SIMMONS MD (NPI 1417534553) is an individual family medicine provider in Stone Mountain, Georgia, licensed in Georgia (100732) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417534553

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. CARMEN SYLVIA SIMMONSCredential: MD

Location AddressPO BOX 870589Stone Mountain, GA 30087-0015

Mailing AddressPo Box 870589Stone Mountain, GA 30087-0015 · (678) 464-1312

Phone(678) 464-1312

Sole ProprietorNo

Enumeration DateMarch 25, 2021

Last NPPES UpdateJuly 16, 20243 updates tracked since enumeration

NPPES CertifiedJuly 16, 2024

✔ NPI 1417534553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in GA · 100732

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

PO BOX 870589, Stone Mountain, GA 30087

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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Carmen Sylvia Simmons Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

Medicare enrollment records show Carmen Simmons reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Vituity-Georgia Hospitalists PC

75 mi

Hospitalist

367 CLEAR CREEK PKWY
Lavonia, GA 30553

Reassigned Medicare billing, Georgia enrollment
30 clinicians in this Medicare group

NPI 1366291882 (706) 356-7800

Crisp Regional Hospital Inc

128 mi

General Acute Care Hospital

902 7TH ST NORTH
Cordele, GA 31010

Reassigned Medicare billing, Georgia enrollment
124 clinicians in this Medicare group

NPI 1700851649 (229) 271-9686

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30087 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

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.

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 Carmen Simmons's NPI number?

The NPI number for Carmen Simmons is 1417534553. It was assigned to this individual provider in the NPPES registry on March 25, 2021.

Where is Carmen Simmons located?

Carmen Simmons practices at PO Box 870589, Stone Mountain, GA 30087. The listed phone number is (678) 464-1312.

What is Carmen Simmons's specialty?

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

Is Carmen Simmons enrolled in Medicare?

Yes. Carmen Simmons is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Carmen Simmons's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carmen Simmons reassigns Medicare benefits to 2 organizations: Vituity-Georgia Hospitalists PC (Lavonia, GA) and Crisp Regional Hospital Inc (Cordele, GA). 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 Carmen Simmons's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carmen Simmons accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health and Oscar Health list Carmen 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.

When was this NPI record last updated?

The NPPES record for Carmen Simmons was last updated on July 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.