RICHARD S SIMMONS II MD
NPI 1417942293
Internal Medicine - Pulmonary Disease in Lagrange, GA


Quality Rating: 92.93 out of 100 score

NPI Status: Active since September 16, 2005

Contact Information

1551 DOCTORS DRIVE
BUILDING 200
LAGRANGE, GA
ZIP 30240
Phone: (706) 884-3389
Fax: (706) 880-7223

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  • Individual
  • Male
  • Internal Medicine
  • Pulmonary Disease

About RICHARD SIMMONS

This page provides the complete NPI Profile along with additional information for Richard Simmons, an internist established in Lagrange, Georgia with a medical specialization in Internal Medicine, focusing in pulmonary disease . The healthcare provider is registered in the NPI registry with number 1417942293 assigned on September 2005. The practitioner's primary taxonomy code is 207RP1001X with license number 28651 (GA). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1417942293
Provider Name
RICHARD S SIMMONS II MD
Gender
Male
Entity Type
Individual
Location Address
1551 DOCTORS DRIVE BUILDING 200 LAGRANGE, GA 30240
Location Phone
(706) 884-3389
Location Fax
(706) 880-7223
Mailing Address
1551 DOCTORS DRIVE BUILDING 200 LAGRANGE, GA 30240
Mailing Phone
(706) 884-3389
Mailing Fax
(706) 880-7223
Is Sole Proprietor?
No
Enumeration Date
09-16-2005
Last Update Date
10-03-2019
Code Navigator

An internist like Richard Simmons is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Pulmonary Disease

Taxonomy Code
207RP1001X
Type
Allopathic & Osteopathic Physicians
License No.
28651
License State
GA
Taxonomy Description
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1174400000XOther Service Providers

Specialist

028651 (GA)
2174400000XOther Service Providers

Specialist

28651 (GA)
3207RS0012XAllopathic & Osteopathic Physicians

Internal Medicine
Sleep Medicine

28651 (GA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
00327533AMEDICAID (05)GA 

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 231 times for 165 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 128 times for 87 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 21 times for 21 patients

Sleep study in sleep lab with continuous airway pressure (6 years or older)

A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.

This service was performed 18 times for 18 patients

Sleep study including heart rate, breathing, airflow, and effort

A sleep study monitors your heart rate, breathing patterns, airflow, and physical effort while you sleep. It helps identify sleep disorders by tracking your sleep stages and cycles. This data aids doctors in diagnosing and treating sleep-related issues.

This service was performed 11 times for 11 patients

Test for exercise-induced lung stress

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

This service was performed 21 times for 20 patients

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.93, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 92.93 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 80.38

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1417942293, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
1
Doubled → 2
Pos 4
7
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
4
Unchanged
Pos 7
2
Doubled → 4
Pos 8
2
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 9 → 18 → 9 2 → 4 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 2 + 7 + 1 + 8 + 4 + 4 + 2 + 1 + 8 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1417942293.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Internal Medicine (Interventional Cardiology)
1551 DOCTORS DRIVE, BLDG 200
LAGRANGE, GA 30240
Specialist
1551 DOCTORS DRIVE
LAGRANGE, GA 30240
Physician Assistant (Medical)
1551 DOCTORS DRIVE
LAGRANGE, GA 30240
Internal Medicine (Gastroenterology)
1551 DOCTORS DRIVE
LAGRANGE, GA 30240

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417942293, enumerated as an "individual" on September 16, 2005.

The provider is located at 1551 DOCTORS DRIVE BUILDING 200 LAGRANGE, GA 30240 and the phone number is (706) 884-3389.

Internal Medicine with taxonomy code 207RP1001X and a focus in Pulmonary Disease.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.