DR. MATTHEW JOHN SIMONS M.D.
NPI 1689816266
Orthopaedic Surgery in Fresno, CA

Active since March 30, 2009PECOS EnrolledAccepts Medicare Assignment
85.78/100
CMS Quality Rating
1630 E HERNDON AVE, FRESNO, CA 93720(559) 256-5396(559) 432-8364 Get Directions Write a Review

NPPES record last updated: May 11, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Matthew John Simons M.d. NPPES

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

DR. MATTHEW JOHN SIMONS M.D. (NPI 1689816266) is an individual orthopaedic surgery provider in Fresno, California, licensed in California (A135495) and active in the NPI registry since March 2009. He is enrolled in Medicare PECOS and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2009).

NPPES Registry Identity

NPI1689816266
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. MATTHEW JOHN SIMONSCredential: M.D.
Location Address1630 E HERNDON AVEFresno, CA 93720-3391
Mailing Address1630 E Herndon AveFresno, CA 93720-3391 · (559) 256-5396 · Fax (559) 432-8364
Fax(559) 432-8364
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2009
Enumeration DateMarch 30, 2009
Last NPPES UpdateMay 11, 2016
NPI 1689816266 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in CA · A135495
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1630 E HERNDON AVE, Fresno, CA 93720

Other Identifiers 1

Medicare PINCA160176CA

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. Matthew John Simons 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 ID840504239
PECOS Enrollment IDI20150729008613
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 28

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.

Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg J7328
Gelsyn-3 is a treatment involving injections of a substance called hyaluronan into the joint space. Hyaluronan is naturally present in healthy joint fluid, aiding in lubrication and shock absorption. This treatment helps relieve joint pain, often in conditions like osteoarthritis.
15,120 services38 patients
Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg J7318
Hyaluronan or derivative, Durolane, is a treatment injected directly into the joint to relieve pain and improve mobility. It's often used for arthritis in the knee. The substance works by supplementing your body's natural joint fluid to help lubricate and cushion the joint.
3,900 services41 patients
Injection, ropivacaine hydrochloride, 1 mg J2795
Ropivacaine hydrochloride is a local anesthetic used to numb specific areas of your body during minor surgical procedures or to relieve pain. The medicine is injected into the area requiring anesthesia.
1,797 services42 patients
X-ray of knee, 3 views 73562
An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
655 services480 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
472 services77 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.
453 services366 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93720 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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.

85.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality91.3
Promoting Interoperability100
Improvement Activities40
Cost61.3

Reported Quality Measures

Risk-standardized complication rate (RSCR) following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA) for Merit-based Incentive Payment System (MIPS)
Lower rates are better for this measure.
0.03%
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

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

Walker, folding, wheeled, adjustable or fixed height E0143
DME-Other DME · category DE000N
5 suppliers30 claims30 services$38.61 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.

Orthopaedic Surgery
1630 E HERNDON AVE
FRESNO, CA 93720
Orthopaedic Surgery
1630 E HERNDON AVE
FRESNO, CA 93720
Pain Medicine (Pain Medicine)
1630 E HERNDON AVE
FRESNO, CA 93720
Orthopaedic Surgery
1630 E HERNDON AVE
FRESNO, CA 93720
Family Medicine
1630 E HERNDON AVE
FRESNO, CA 93720
Orthopaedic Surgery
1630 E HERNDON AVE
FRESNO, CA 93720
Orthopaedic Surgery
1630 E HERNDON AVE
FRESNO, CA 93720
Physician Assistant (Medical)
1630 E HERNDON AVE
FRESNO, CA 93720

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 Matthew Simons's NPI number?

The NPI number for Matthew Simons is 1689816266. It was assigned to this individual provider in the NPPES registry on March 30, 2009.

Where is Matthew Simons located?

Matthew Simons practices at 1630 E Herndon Ave, Fresno, CA 93720. The listed phone number is (559) 256-5396.

What is Matthew Simons's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Matthew Simons enrolled in Medicare?

Yes. Matthew Simons 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.

When was this NPI record last updated?

The NPPES record for Matthew Simons was last updated on May 11, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.