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TIMOTHY SIMON MD
NPI 1609824416
Colon & Rectal Surgery in Decatur, GA

Active since May 04, 2006PECOS EnrolledAccepts Medicare Assignment
2801 N DECATUR RD, SUITE 120, DECATUR, GA 30033(770) 277-4277(404) 292-6305 Get Directions Write a Review

NPPES record last updated: February 26, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 26, 2021, Nov 20, 2018, Jan 10, 2017 (3 updates tracked since 2017).

About Timothy Simon Md NPPES

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

TIMOTHY SIMON MD (NPI 1609824416) is an individual colon & rectal surgery provider in Decatur, Georgia, licensed in Georgia (040846) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Emory Decatur Hospital, and is a graduate of Howard University College Of Medicine (1993).

NPPES Registry Identity

NPI1609824416
Entity TypeIndividualMale
Primary Taxonomy208C00000X
Provider Legal NameTIMOTHY SIMONCredential: MD
Location Address2801 N DECATUR RD, SUITE 120Decatur, GA 30033-5949
Mailing Address2801 N Decatur Rd, Suite 120Decatur, GA 30033-5949 · (770) 277-4277 · Fax (404) 292-6305
Phone(770) 277-4277
Fax(404) 292-6305
Sole ProprietorNo
Medical School CMSHoward University College Of MedicineGraduated 1993
Enumeration DateMay 4, 2006
Last NPPES UpdateFebruary 26, 20213 updates tracked since enumeration
NPPES CertifiedFebruary 26, 2021
✔ NPI 1609824416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License✔ Licensed in GA · 040846
Definition
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
2801 N DECATUR RD, Decatur, GA 30033
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Other Identifiers 7

Other52439381Bcbs
Other4608346001Cigna Hmo
Medicaid00947086AGA
Other2969776Aetna Hmo
Other10556Kaiser
Other1700465United Healthcare
Other7375431Aetna Non Hmo

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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

Timothy Simon 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 ID1355466194
PECOS Enrollment IDI20100916000384
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 5

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 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.
135 services80 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.
28 services28 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.
17 services17 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.
14 services12 patients
Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery 45384
This procedure involves using a flexible tube with a camera, called an endoscope, to view the large intestine. If any abnormal growths or polyps are found, they are removed with an electrically-heated instrument. This is a common way to prevent bowel issues.
12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Emory Decatur Hospital

Acute Care Hospitals · Decatur, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110076
Location2701 N Decatur RoadDecatur, GA 30033 · De Kalb County
Emergency services Birthing friendly

Emory University Hospital Midtown

Acute Care Hospitals · Atlanta, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110078
Location550 Peachtree Street, NEAtlanta, GA 30308 · Fulton County
Emergency services Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30033 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
87%75 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
61%75 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
99%110 patients4/55-star benchmark: 100%
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
77%43 patients4/55-star benchmark: 100%
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 4

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

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
2 suppliers16 claims440 services$4.37 avg. paid by Medicare
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394
DME-Orthotic Devices · category DF010N
3 suppliers23 claims324 services$2.46 avg. paid by Medicare
Ostomy skin barrier, pectin-based, paste, per ounce A4406
DME-Orthotic Devices · category DF010N
5 suppliers30 claims148 services$5.31 avg. paid by Medicare
Ostomy pouch, closed; for use on barrier with flange (2 piece), each A5054
DME-Orthotic Devices · category DF010N
1 supplier12 claims720 services$1.74 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 20

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

TIFFANY A CLERK DPT
Physical Therapist
2801 N DECATUR RD, SUITE 230
DECATUR, GA 30033
Dekalb County (404) 294-7211
DR. NICHOLAS CHURCH MD
Family Medicine
2801 N DECATUR RD, SUITE 295
DECATUR, GA 30033
Dekalb County (404) 778-6400
DONALD C SIEGEL MD PC
Surgery
2801 N DECATUR RD, SUITE 180
DECATUR, GA 30033
Dekalb County (404) 297-0098
ATLANTA SPINE SPECIALISTS, LLC
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
2801 N DECATUR RD, STE 200
DECATUR, GA 30033
Dekalb County (404) 296-5005
DONALD C, SIEGEL, M.D., F.A.C.S.
Emergency Medical Technician, Intermediate
2801 N DECATUR RD
DECATUR, GA 30033
Dekalb County (404) 297-0098
TARA GAMBILL DPT
Physical Therapist
2801 N DECATUR RD, SUITE 230
DECATUR, GA 30033
Dekalb County (404) 294-7211
JEAN H. FIEDLER MD
Internal Medicine
2801 N DECATUR RD, SUITE 295
DECATUR, GA 30033
Dekalb County (404) 778-6400
OMS, LLC
Physician Assistant
2801 N DECATUR RD
DECATUR, GA 30033
Dekalb County (404) 296-5005

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 Timothy Simon's NPI number?

The NPI number for Timothy Simon is 1609824416. It was assigned to this individual provider in the NPPES registry on May 4, 2006.

Where is Timothy Simon located?

Timothy Simon practices at 2801 N Decatur Rd Suite 120, Decatur, GA 30033. The listed phone number is (770) 277-4277.

What is Timothy Simon's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Timothy Simon enrolled in Medicare?

Yes. Timothy Simon 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 Timothy Simon accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Timothy Simon 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 Timothy Simon affiliated with any hospitals?

According to CMS data, Timothy Simon is affiliated with Emory Decatur Hospital, Emory University Hospital Midtown and Northside Hospital.

When was this NPI record last updated?

The NPPES record for Timothy Simon was last updated on February 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.