DR. STEPHEN JUSTIN SIMS MD
NPI 1568453264
Family Medicine in Mountain View, CA

Q: What is Stephen Sims's NPI number?

The NPI number for Stephen Sims is 1568453264. It was assigned to this individual provider in the NPPES registry on November 2, 2005.

Q: What is Stephen Sims'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 Stephen Sims was last updated on February 27, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since November 02, 2005PECOS EnrolledAccepts Medicare AssignmentCLIA 05D0971035 · Microscopy

88.04/100

CMS Quality Rating

525 SOUTH DR STE 107, MOUNTAIN VIEW, CA 94040(650) 386-0386(650) 386-0468 Get Directions Write a Review

NPPES record last updated: February 27, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 27, 2025, Mar 25, 2021 (2 updates tracked since 2021).

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About Dr. Stephen Justin Sims Md NPPES

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

DR. STEPHEN JUSTIN SIMS MD (NPI 1568453264) is an individual family medicine provider in Mountain View, California, licensed in California (G69269) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, holds a CLIA Microscopy certificate valid through March 1, 2028, and is a graduate of State University Of New York Downstate Medical Center (1989).

NPPES Registry Identity

NPI1568453264

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. STEPHEN JUSTIN SIMSCredential: MD

Location Address525 SOUTH DR STE 107Mountain View, CA 94040-4211

Mailing Address525 South Dr Ste 107Mountain View, CA 94040-4211 · (650) 386-0386 · Fax (650) 386-0468

Phone(650) 386-0386

Fax(650) 386-0468

Sole ProprietorNo

Medical School CMSState University Of New York Downstate Medical CenterGraduated 1989

Enumeration DateNovember 2, 2005

Last NPPES UpdateFebruary 27, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 27, 2025

✔ NPI 1568453264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · G69269

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.

525 SOUTH DR STE 107, Mountain View, CA 94040

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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. Stephen Justin Sims Md 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 ID840468104

PECOS Enrollment IDI20110713000173

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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0971035

Stephen Sims MD · Mountain View, CA

Active · expires Mar 1, 2028

CLIA Number05D0971035

Laboratory TypePhysician Office

Certificate Effective DateMarch 2, 2026

Certificate Expiration DateMarch 1, 2028

Laboratory DirectorStephen J. Sims

Laboratory Phone(650) 386-0386

Laboratory LocationStephen Sims MD525 South Dr, Ste 107, Mountain View, CA 94040

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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.

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.

659 services317 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.

515 services252 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

224 services224 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

223 services223 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

186 services181 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

175 services174 patients

Ultrasound of one side of head and neck blood flow 93882

An ultrasound of one side of the head and neck blood flow is a non-invasive procedure that uses sound waves to create images of blood vessels. It helps identify any blockages or abnormalities in blood flow, aiding in early detection of potential health issues.

148 services144 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

61 services61 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

52 services34 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

48 services48 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

41 services19 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

26 services26 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

23 services23 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.

17 services17 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

17 services17 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

14 services11 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

14 services14 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

12 services12 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94040 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

$106.47 typical visit price

range $70.37 – $206.04

Typical copayment $26.61 (range $17.59 – $51.51)

Most-billed visit code 99203

Established Patient

$121.77 typical visit price

range $23.96 – $169.60

Typical copayment $30.44 (range $5.99 – $42.40)

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.

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.

88.04/100

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

Individually scored

Quality

76.09

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Appropriate Treatment for Upper Respiratory Infection (URI)

100%26 patients5/55-star benchmark: 100%

Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture

Lower rates are better for this measure.

4%139 patients

Breast Cancer Screening

55%291 patients3/55-star benchmark: 93%

Cervical Cancer Screening

15%533 patients1/55-star benchmark: 98%

Colorectal Cancer Screening

55%1,095 patients3/55-star benchmark: 88%

Controlling High Blood Pressure

64%356 patients3/55-star benchmark: 91%

Diabetes: Eye Exam

31%162 patients2/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

30%162 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

41%4,960 patients1/55-star benchmark: 100%

e-Prescribing

100%1,258 patients5/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

85%454 patients4/55-star benchmark: 100%

HIV Screening

13%1,748 patients1/55-star benchmark: 60%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

43%2,129 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

78%1,927 patients4/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 80% · 1,780 patients

Patients screened: 81% · 1,780 patients

40%52 patients2/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

100%1,113 patients5/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

69%941 patients3/55-star benchmark: 91%

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.

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers32 claims80 services$5.44 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers18 claims28 services$0.76 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

3 suppliers39 claims39 services$30.53 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

2 suppliers28 claims163 services$13.34 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

3 suppliers13 claims68 services$12.02 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

3 suppliers41 claims41 services$41.24 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

DIANA LYN HENDRY MS, RD, CDE

Dietitian, Registered

525 SOUTH DR STE 107
MOUNTAIN VIEW, CA 94040

Santa Clara County (650) 386-0483

MS. YESIM KANLIOGLU P.A

Physician Assistant

525 SOUTH DR STE 107
MOUNTAIN VIEW, CA 94040

Santa Clara County (650) 386-0386

RACHEL DEE MOORMAN PA-C

Physician Assistant

525 SOUTH DR STE 107
MOUNTAIN VIEW, CA 94040

Santa Clara County (650) 386-0386

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 Stephen Sims's NPI number?

The NPI number for Stephen Sims is 1568453264. It was assigned to this individual provider in the NPPES registry on November 2, 2005.

Where is Stephen Sims located?

Stephen Sims practices at 525 South Dr Ste 107, Mountain View, CA 94040. The listed phone number is (650) 386-0386.

What is Stephen Sims's specialty?

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

Is Stephen Sims enrolled in Medicare?

Yes. Stephen 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.

Does Stephen Sims hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0971035) is associated with this NPI, valid through March 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Stephen Sims was last updated on February 27, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

About Dr. Stephen Justin Sims Md NPPES

NPPES Registry Identity

Specialties & Licenses

Medicare Participation & PECOS CMS

Medicare Enrollment Status

CLIA Laboratory Certificates CMS CLIA

Certificate for Provider-Performed Microscopy Procedures (PPMP) · 05D0971035

Areas of Expertise CMS Part B claims 19

Physician Visit Costs CMS claims · ZIP area

Medicare Quality Performance CMS QPP · MIPS

Reported Quality Measures

Referred Medical Equipment & Supplies CMS DME claims 9

Other Providers at the Same Location NPPES 3

Frequently Asked Questions NPPES & CMS

What is Stephen Sims's NPI number?

Where is Stephen Sims located?

What is Stephen Sims's specialty?

Is Stephen Sims enrolled in Medicare?

Does Stephen Sims hold a CLIA laboratory certificate?

When was this NPI record last updated?

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0971035