LINDA A SIMMONS CRNP
NPI 1497087902
Nurse Practitioner - Family in Wilmington, DE
NPI Status: Active since February 08, 2010
Contact Information
501 W 14TH ST FL 4
WILMINGTON, DE
ZIP 19801
Phone: (302) 661-3070
Fax: (302) 661-3080
- Individual
- Female
- Nurse Practitioner
- Family
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About LINDA SIMMONS
This page provides the complete NPI Profile along with additional information for Linda Simmons, a provider established in Wilmington, Delaware with a medical specialization in Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1497087902 assigned on February 2010. The practitioner's primary taxonomy code is 363LF0000X with license number LG-0001158 (DE). The provider is registered as an individual and her NPI record was last updated 6 years ago.
- NPI
- 1497087902
- Provider Name
- LINDA A SIMMONS CRNP
- Other Name
- LINDA MCCULLION SIMMONS CRNP
- Other Name Type
- Professional Name (2)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 501 W 14TH ST FL 4 WILMINGTON, DE 19801
- Location Phone
- (302) 661-3070
- Location Fax
- (302) 661-3080
- Mailing Address
- 501 W 14TH ST FL 4 WILMINGTON, DE 19801
- Mailing Phone
- (302) 661-3070
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-08-2010
- Last Update Date
- 04-23-2020
- Code Navigator
A nurse practitioner (NP) like Linda Simmons is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, 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
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- LG-0001158
- License State
- DE
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) |
|---|---|---|---|---|
| 1 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | SP010672 (PA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
- AmeriHealth Caritas Next Gold Premier + No Referrals - HMO
- AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
- AmeriHealth Caritas Next Silver Essential + No Referrals - HMO
- AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
- AmeriHealth Caritas Next Silver Signature + No Referrals - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Linda Simmons is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
25 DME suppliers used 59 Medicare Claims 235 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
9 DME suppliers used 15 Medicare Claims 33 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
17 DME suppliers used 104 Medicare Claims 104 Services Paid
Unknown
Treatment-Injections and Infusions (nononcologic) (RI000N)
Insulin for administration through dme (i.e., insulin pump) per 50 units (HCPCS:J1817)
4 DME suppliers used 11 Medicare Claims 1320 Services Paid
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.
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 30-39 minutes
New patient office or other outpatient visit, 60-74 minutes
New patient office or other outpatient visit, 60-74 minutes
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
This service was performed 22 times for 17 patientsThis procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
This service was performed 23 times for 19 patientsThis 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 141 times for 111 patientsThis 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 116 times for 85 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 24 times for 24 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 13 times for 13 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 19801 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $88.37
- Minimum New Patient Price $57.12
- Maximum New Patient Price $173.08
- Average New Patient Copayment $22.09
- Minimum New Patient Copayment $14.28
- Maximum New Patient Copayment $43.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.68
- Minimum Established Patient Price $18.36
- Maximum Established Patient Price $141.05
- Average Established Patient Copayment $25.17
- Minimum Established Patient Copayment $4.59
- Maximum Established Patient Copayment $35.26
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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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 1497087902, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
WILMINGTON, DE 19801
WILMINGTON, DE 19801
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497087902, enumerated as an "individual" on February 08, 2010.
The provider is located at 501 W 14TH ST FL 4 WILMINGTON, DE 19801 and the phone number is (302) 661-3070.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
The provider might be accepting Accepts: AmeriHealth Caritas Next. Please consult your insurance carrier or call the provider to verify.
