DR. MARCUS CERI SIMS M.D.
NPI 1427199546
Internal Medicine - Cardiovascular Disease in Lawrenceville, GA

Q: What is Marcus Sims's NPI number?

The NPI number for Marcus Sims is 1427199546. It was assigned to this individual provider in the NPPES registry on February 9, 2007.

Q: What is Marcus Sims's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Marcus Sims was last updated on June 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 February 09, 2007PECOS EnrolledAccepts Medicare Assignment

90.8/100

CMS Quality Rating

766 WALTHER RD, SUITE 100, LAWRENCEVILLE, GA 30046(678) 312-9100(678) 312-9101 Get Directions Write a Review

NPPES record last updated: June 7, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Marcus Ceri Sims M.d. NPPES

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

DR. MARCUS CERI SIMS M.D. (NPI 1427199546) is an individual cardiovascular disease provider in Lawrenceville, Georgia, licensed in Georgia (060507) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS, is affiliated with Piedmont Walton Hospital, and is a graduate of Morehouse School Of Medicine (2001).

NPPES Registry Identity

NPI1427199546

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameDR. MARCUS CERI SIMSCredential: M.D.

Location Address766 WALTHER RD, SUITE 100Lawrenceville, GA 30046-8764

Mailing Address766 Walther Rd, Suite 100Lawrenceville, GA 30046-8764 · (678) 312-9100 · Fax (678) 312-9101

Phone(678) 312-9100

Fax(678) 312-9101

Sole ProprietorNo

Medical School CMSMorehouse School Of MedicineGraduated 2001

Enumeration DateFebruary 9, 2007

Last NPPES UpdateJune 7, 2013

✔ NPI 1427199546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in GA · 060507

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

766 WALTHER RD, Lawrenceville, GA 30046

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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. Marcus Ceri Sims 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 ID1850474016

PECOS Enrollment IDI20080605000485

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.

Areas of Expertise CMS Part B claims 19

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

607 services426 patients

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.

579 services317 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

167 services161 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

166 services128 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

79 services75 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

64 services64 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

57 services57 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

47 services46 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

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.

35 services35 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

30 services30 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.

30 services29 patients

Technetium tc-99m tetrofosmin, diagnostic, per study dose A9502

Technetium Tc-99m Tetrofosmin is a radiopharmaceutical used in diagnostic imaging. It helps highlight areas of concern in the heart by emitting signals captured by a special camera. This assists doctors in detecting heart conditions.

28 services16 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

26 services26 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

21 services20 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

20 services20 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

19 services19 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician 93015

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

18 services18 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

16 services16 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Piedmont Walton Hospital

Acute Care Hospitals · Monroe, GA

4/5 CMS rating

OwnershipProprietary

CMS Certification Number110046

Location2151 W Spring StreetMonroe, GA 30655 · Walton County

Emergency services Birthing friendly

Piedmont Athens Regional Medical Center

Acute Care Hospitals · Athens, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110074

Location1199 Prince AvenueAthens, GA 30606 · Clarke County

Birthing friendly

Piedmont Hospital

Acute Care Hospitals · Atlanta, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110083

Location1968 Peachtree Rd NWAtlanta, GA 30309 · Fulton County

Emergency services Birthing friendly

Piedmont Rockdale Hospital

Acute Care Hospitals · Conyers, GA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number110091

Location1412 Milstead Avenue, NEConyers, GA 30012 · Rockdale County

Birthing friendly

Piedmont Eastside Medical Center

Acute Care Hospitals · Snellville, GA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number110192

Location1700 Medical WaySnellville, GA 30078 · Gwinnett County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30046 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

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

Most-billed visit code 99213

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.

90.8/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

80%270 patients4/55-star benchmark: 99%

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.

56%3,059 patients1/55-star benchmark: 99%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

83%577 patients4/55-star benchmark: 99%

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.

92%1,060 patients3/55-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.

72%1,366 patients3/55-star benchmark: 97%

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

2%1,375 patients1/55-star benchmark: 96%

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…

100%1,366 patients5/55-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…

18%1,366 patients1/55-star benchmark: 89%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 542 patients

0%542 patients5/55-star benchmark: 100%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

11%1,366 patients

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.

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Other Providers at the Same Location NPPES 8

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

MICHAEL A. LIPSITT MD

Internal Medicine (Cardiovascular Disease)

766 WALTHER RD, SUITE 100
LAWRENCEVILLE, GA 30046

Gwinnett County (678) 312-9100

KATHERINE MARY SIEDOR PA

Physician Assistant (Medical)

766 WALTHER RD, SUITE 100
LAWRENCEVILLE, GA 30046

Gwinnett County (678) 312-9100

LEMUEL G VILLANUEVA MD

Obstetrics & Gynecology

766 WALTHER RD, SUITE 200
LAWRENCEVILLE, GA 30046

Gwinnett County (770) 963-2485

DR. AJAZ L CHAUDHRY M.D.

Otolaryngology

766 WALTHER RD, SUITE 300
LAWRENCEVILLE, GA 30046

Gwinnett County (770) 237-3000

GREGORY TODD FOUNTAIN MD

Obstetrics & Gynecology

766 WALTHER RD, SUITE 100
LAWRENCEVILLE, GA 30046

Gwinnett County (678) 985-8001

MARC I. UNTERMAN MD

Internal Medicine (Cardiovascular Disease)

766 WALTHER RD, SUITE 100
LAWRENCEVILLE, GA 30046

Gwinnett County (678) 312-9100

ATLANTA GWINNETT WOMEN'S SPECIALISTS

Obstetrics & Gynecology

766 WALTHER RD, SUITE 100
LAWRENCEVILLE, GA 30046

Gwinnett County (770) 963-2485

GWINNETT HEART SPECIALISTS LLC

Internal Medicine (Cardiovascular Disease)

766 WALTHER RD, SUITE 100
LAWRENCEVILLE, GA 30046

Gwinnett County (678) 312-5625

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 Marcus Sims's NPI number?

The NPI number for Marcus Sims is 1427199546. It was assigned to this individual provider in the NPPES registry on February 9, 2007.

Where is Marcus Sims located?

Marcus Sims practices at 766 Walther Rd Suite 100, Lawrenceville, GA 30046. The listed phone number is (678) 312-9100.

What is Marcus Sims's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Marcus Sims enrolled in Medicare?

Yes. Marcus Sims 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 Marcus Sims accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Marcus Sims 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 Marcus Sims affiliated with any hospitals?

According to CMS data, Marcus Sims is affiliated with Piedmont Walton Hospital, Piedmont Athens Regional Medical Center, Piedmont Hospital, Piedmont Rockdale Hospital and Piedmont Eastside Medical Center.

When was this NPI record last updated?

The NPPES record for Marcus Sims was last updated on June 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.