NATHANIEL SIMMONS
NPI 1487008181
Ophthalmology in Orchard Park, NY

Q: What is Nathaniel Simmons's NPI number?

The NPI number for Nathaniel Simmons is 1487008181. It was assigned to this individual provider in the NPPES registry on April 19, 2016.

Q: What is Nathaniel Simmons's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Nathaniel Simmons was last updated on September 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 April 19, 2016PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

3151 SOUTHWESTER BLVD, ORCHARD PARK, NY 14127(716) 674-6030 Get Directions Write a Review

NPPES record last updated: September 27, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Nathaniel Simmons NPPES

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

NATHANIEL SIMMONS (NPI 1487008181) is an individual ophthalmology provider in Orchard Park, New York, licensed in New York (301186) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS and is a graduate of Tufts University School Of Medicine (2016).

NPPES Registry Identity

NPI1487008181

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameNATHANIEL SIMMONS

Location Address3151 SOUTHWESTER BLVDOrchard Park, NY 14127

Mailing Address3151 Southwester BlvdOrchard Park, NY 14127-0001 · (716) 674-6030

Phone(716) 674-6030

Sole ProprietorNo

Medical School CMSTufts University School Of MedicineGraduated 2016

Enumeration DateApril 19, 2016

Last NPPES UpdateSeptember 27, 2022

NPPES CertifiedSeptember 21, 2022

✔ NPI 1487008181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in NY · 301186

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

3151 SOUTHWESTER BLVD, Orchard Park, NY 14127

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Nathaniel Simmons 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 ID42636136

PECOS Enrollment IDI20200819003972

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

Provider Profile

Same address

Ophthalmology

3151 SOUTHWESTERN BLVD
Orchard Park, NY 14127

Reassigned Medicare billing, New York enrollment
3 clinicians in this Medicare group

NPI 1932111762 (716) 674-6030

Southtowns Ophthalmology PC

Same address

Ophthalmology

3151 SOUTHWESTERN BLVD
Orchard Park, NY 14127

Reassigned Medicare billing, New York enrollment
6 clinicians in this Medicare group

NPI 1619407517 (716) 674-6030

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

Areas of Expertise CMS Part B claims 13

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.

361 services360 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

217 services215 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.

206 services164 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

130 services126 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

124 services52 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

71 services66 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

67 services42 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.

50 services50 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

40 services36 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

25 services20 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

23 services19 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

13 services13 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14127 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

$126.40 typical visit price

range $54.87 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$68.57 typical visit price

range $17.54 – $136.14

Typical copayment $17.14 (range $4.38 – $34.03)

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.

100/100

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

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

100

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 Nathaniel Simmons's NPI number?

The NPI number for Nathaniel Simmons is 1487008181. It was assigned to this individual provider in the NPPES registry on April 19, 2016.

Where is Nathaniel Simmons located?

Nathaniel Simmons practices at 3151 Southwester Blvd, Orchard Park, NY 14127. The listed phone number is (716) 674-6030.

What is Nathaniel Simmons's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Nathaniel Simmons enrolled in Medicare?

Yes. Nathaniel 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 Nathaniel Simmons's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nathaniel Simmons reassigns Medicare benefits to 2 organizations: (Orchard Park, NY) and Southtowns Ophthalmology PC (Orchard Park, NY). 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 Nathaniel Simmons's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nathaniel Simmons accept?

Health plans from Anthem Blue Cross and Blue Shield list Nathaniel 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 Nathaniel Simmons was last updated on September 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.