DR. ANTHONY J. SIMONS M.D.
NPI 1811995053
Colon & Rectal Surgery in Longview, WA

NPI Status: Active since July 12, 2005

Contact Information

1615 DELAWARE ST
SUITE 200
LONGVIEW, WA
ZIP 98632
Phone: (360) 501-3500
Fax: (360) 501-3555

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  • Individual
  • Male
  • Years of Experience 36
  • Colon & Rectal Surgery
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About ANTHONY SIMONS

Anthony Simons is a provider established in Longview, Washington and his medical specialization is Colon & Rectal Surgery with more than 36 years of experience. The healthcare provider is registered in the NPI registry with number 1811995053 assigned on July 2005. The practitioner's primary taxonomy code is 208C00000X with license number MD00034692 (WA). The provider is registered as an individual and his NPI record was last updated 17 years ago.

NPI
1811995053
Provider Name
DR. ANTHONY J. SIMONS M.D.
Gender
Male
Entity Type
Individual
Location Address
1615 DELAWARE ST SUITE 200 LONGVIEW, WA 98632
Location Phone
(360) 501-3500
Location Fax
(360) 501-3555
Mailing Address
PO BOX 3002 LONGVIEW, WA 98632
Mailing Phone
(360) 414-2048
Mailing Fax
(360) 501-3555
Medical School Name
OTHER
Graduation Year
1988
Is Sole Proprietor?
No
Enumeration Date
07-12-2005
Last Update Date
11-14-2007
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Anthony Simons is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.63 for a new patient copayment and $18.43 for an established patient copayment.

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

Colon & Rectal Surgery

Taxonomy Code
208C00000X
Type
Allopathic & Osteopathic Physicians
License No.
MD00034692
License State
WA
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BridgeSpan Health Company

    • BridgeSpan Standard Bronze Plan - EPO
    • BridgeSpan Standard Gold Plan - EPO
    • BridgeSpan Standard Silver Plan - EPO
  • Kaiser Permanente

    • KP OR Bronze 5500/50 - EPO
    • KP OR Bronze 7100/0% HSA - EPO
    • KP OR Bronze 9100/75 - EPO
    • KP OR Gold 0/15 - EPO
    • KP OR Gold 1750/20 - EPO
    • KP OR Silver 3000/40 - EPO
    • KP OR Silver 4000/40 - EPO
    • KP OR Silver 750/35 - EPO
    • KP Oregon Standard Bronze Plan - EPO
    • KP Oregon Standard Gold Plan - EPO
  • Moda Health Plan, Inc.

    • Moda Health Affinity Bronze 7750 - EPO
    • Moda Health Affinity Bronze 9000 - EPO
    • Moda Health Affinity Bronze HSA 7500 - EPO
    • Moda Health Affinity Gold 1000 - EPO
    • Moda Health Affinity Gold 250 - EPO
    • Moda Health Affinity Silver 3500 - EPO
    • Moda Health Affinity Silver 4500 - EPO
    • Moda Health Affinity Silver 6400 - EPO
    • Moda Health Oregon Standard Bronze Plan (Affinity) - EPO
    • Moda Health Oregon Standard Gold (Affinity) - EPO
  • PacificSource Health Plans

    • Navigator Bronze 7000 - PPO
    • Navigator Bronze 7000 Exchange - PPO
    • Navigator Bronze 9400 - PPO
    • Navigator Bronze 9400 Exchange - PPO
    • Navigator Bronze HSA 7500 - PPO
    • Navigator Gold 1500 - PPO
    • Navigator Gold 1500 Exchange - PPO
    • Navigator Gold 500 Exchange - PPO
    • Navigator Silver 3500 Exchange - PPO
    • Navigator Silver 4000 Exchange - PPO
  • Providence Health Plan

    • HSA Qualified 7100 Bronze - Signature Network - EPO
    • HSA Qualified 7100 Bronze - Choice Network - EPO
    • Providence Oregon Standard Bronze Plan - Choice Network - EPO
    • Providence Oregon Standard Bronze Plan - Signature Network - EPO
    • Providence Oregon Standard Gold Plan - Choice Network - EPO
    • Providence Oregon Standard Gold Plan - Signature Network - EPO
    • Providence Oregon Standard Silver Plan - Choice Network - EPO
    • Providence Oregon Standard Silver Plan - Signature Network - EPO
  • Regence BlueCross BlueShield of Oregon

    • Bronze Essential 8500 With 4 Copay No Deductible Office Visits Individual and Family Network - EPO
    • Bronze HSA 7000 Individual and Family Network - EPO
    • Bronze HSA 7000 Legacy - EPO
    • Bronze Virtual Value 8500 Individual and Family Network - EPO
    • Bronze Virtual Value 8500 Legacy - EPO
    • Gold 2500 Individual and Family Network - EPO
    • Gold 2500 Legacy - EPO
    • Regence Standard Bronze Plan Individual and Family Network - EPO
    • Regence Standard Bronze Plan Legacy - EPO
    • Regence Standard Gold Plan Individual and Family Network - EPO
  • Medicare

  • Medicaid

  • Railroad Medicare


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
F65809MEDICARE UPIN (02)WA 
8864664MEDICARE PIN (08)WA 
0217054OTHER (01)WALABOR & IND.
P00394870OTHER (01)RAILROAD MEDICARE
8205411MEDICAID (05)WA 
8943481OTHER (01)WACRIME VICTIMS
149992MEDICAID (05)OR 

PECOS Enrollment and Medicare Participation Status

Anthony Simons 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

  • PECOS PAC ID: 8426086604

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20070427000062, I20211228002283

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • 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.

Prosthetic and Orthotic Devices

  • Prosthetic/Orthotic devices (D1F)

    Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each (HCPCS:A4385)

    2 DME suppliers used 13 Medicare Claims 260 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each (HCPCS:A5057)

    2 DME suppliers used 12 Medicare Claims 240 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Skin barrier, wipes or swabs, each (HCPCS:A5120)

    2 DME suppliers used 11 Medicare Claims 550 Services Paid

Physician 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 98632 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $90.52
  • Minimum New Patient Price $58.96
  • Maximum New Patient Price $178.29
  • Average New Patient Copayment $22.63
  • Minimum New Patient Copayment $14.74
  • Maximum New Patient Copayment $44.57

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $73.74
  • Minimum Established Patient Price $18.53
  • Maximum Established Patient Price $145.92
  • Average Established Patient Copayment $18.43
  • Minimum Established Patient Copayment $4.63
  • Maximum Established Patient Copayment $36.48

* 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.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 32

    Removal of polyps or growths of large bowel using an endoscope (HCPCS:45385)

  • 16

    Diagnostic examination of the anus using an endoscope (HCPCS:46600)

  • 15

    Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS:G0105)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Anthony Simons is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
LEGACY GOOD SAMARITAN MEDICAL CENTER1015 NW 22ND AVENUE, W121
PORTLAND, OR 97210
(503) 413-7711Acute Care Hospitals
LEGACY SALMON CREEK MEDICAL CENTER2211 NE 139TH STREET
VANCOUVER, WA 98686
(360) 487-1000Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1811995053
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
282118910010
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 2 + 1 + 1 + 8 + 9 + 1 + 0 + 0 + 1 + 0 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1811995053 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1316943590 R. SCOTT HUGHEY MD
Individual
Internal Medicine1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-2727
1376549337 LINDA K. JOHNSTON ARNP
Individual
Nurse Practitioner (Adult Health)1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-2727
1356348502 MICHAEL LEE BARTLETT MD
Individual
Family Medicine1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-2385
1578560710 SHAWN J. AARON MD
Individual
Family Medicine1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-2385
1952308967 ERIC DONALD OTTENBACHER PA
Individual
Physician Assistant1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-2385
1841297744 JEFF P JOLLY PA
Individual
Physician Assistant1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-2360
1194723346 VIRGINIA S. HUANG M.D.
Individual
Surgery (Plastic and Reconstructive Surgery)1615 DELAWARE ST SUITE 200
LONGVIEW, WA 98632
(360) 501-3500
1396743530DR. DANE L. MOSESON M.D.
Individual
Surgery1615 DELAWARE ST SUITE 200
LONGVIEW, WA 98632
(360) 501-3500
1992703151 STEVEN X. CABRALES M.D.
Individual
Surgery1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 501-3500
1154329324 GEORGE S. FORTNER M.D.
Individual
Surgery (Vascular Surgery)1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 501-3500
1710985817 MARIO D. FORTE M.D.
Individual
Surgery1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 501-3500
1215939905 CLIFFORD J SCHOSTAL MD
Individual
Psychiatry & Neurology (Neurology)1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 636-4814
1508858002 ELEEN A KIRMAN MD
Individual
Anesthesiology1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-2000
1649262171 MICHAEL I MCNELLIS MD
Individual
Internal Medicine (Pulmonary Disease)1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-2730
1881686194 STEPHANIE B ROBERTS PA
Individual
Physician Assistant1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-7878
1508858812 ZAFER YILDIRIM MD,PHD
Individual
Internal Medicine1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-7878
1851385561 JONATHAN Y WONG PA
Individual
Physician Assistant1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-2700
1578553418 EDGAR FOISY CRNA
Individual
Nurse Anesthetist, Certified Registered1615 DELAWARE ST
LONGVIEW, WA 98632
(360) 414-2000
1457335945 KATHRYN B BLACK MD
Individual
Anesthesiology1615 DELAWARE ST ANES. DEPT
LONGVIEW, WA 98632
(360) 425-7280
1891779393 SALLY COMPERE MD
Individual
Anesthesiology1615 DELAWARE ST ANESTHESIA DEPT.
LONGVIEW, WA 98632
(360) 425-7280

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811995053, enumerated in the NPI registry as an "individual" on July 12, 2005

The provider is located at 1615 Delaware St Suite 200 Longview, Wa 98632 and the phone number is (360) 501-3500

The provider's speciality is Colon & Rectal Surgery with taxonomy code 208C00000X

The provider has more than 36 years of experience.

The provider might be accepting Accepts: BridgeSpan Health Company, Kaiser Permanente, Moda. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 17, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

Medicare beneficiaries should expect a typical cost of $90.52 with an average copayment of $22.63 for new patient appointments. Established patients should expect a typical charge of $73.74 and an average copayment of 18.43. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Removal of polyps or growths of large bowel using an endoscope, Diagnostic examination of the anus using an endoscope and Colorectal cancer screening; colonoscopy on individual at high risk.

The practitioner is affiliated to the following hospital(s): LEGACY GOOD SAMARITAN MEDICAL CENTER and LEGACY SALMON CREEK MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on July 12, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.