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SONIA SIMON DPM
NPI 1902460009
Podiatrist in Dallas, TX

Active since April 24, 2019PECOS EnrolledAccepts Medicare Assignment
71.17/100
CMS Quality Rating
12221 MERIT DR STE 280, DALLAS, TX 75251(972) 853-7100 Get Directions Write a Review

NPPES record last updated: July 22, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 22, 2024, Mar 7, 2024, Nov 1, 2022 and 1 more (4 updates tracked since 2019).

About Sonia Simon Dpm NPPES

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

SONIA SIMON DPM (NPI 1902460009) is an individual podiatrist in Dallas, Texas, licensed in Texas (3138) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, is affiliated with North Central Surgical Center Llp, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1902460009
Entity TypeIndividualFemale
Primary Taxonomy213E00000X
Provider Legal NameSONIA SIMONCredential: DPM
Location Address12221 MERIT DR STE 280Dallas, TX 75251-2242
Mailing Address8135 Forest Ln # 515057Dallas, TX 75230-2472
Phone(972) 853-7100
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateApril 24, 2019
Last NPPES UpdateJuly 22, 20244 updates tracked since enumeration
NPPES CertifiedJuly 22, 2024
✔ NPI 1902460009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in TX · 3138
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
12221 MERIT DR STE 280, Dallas, TX 75251
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

Sonia Simon Dpm 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 ID2769869189
PECOS Enrollment IDI20220524001359
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 10

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.
422 services213 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.
134 services134 patients
X-ray of foot, minimum of 3 views 73630
An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.
100 services74 patients
Removal of fingernails or toenails, 6 or more nails 11721
This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
79 services37 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.
53 services48 patients
Removal of tissue from wound, 20.0 sq cm or less 97597
This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.
29 services16 patients

Hospital Affiliations CMS Care Compare

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

North Central Surgical Center LLP

Acute Care Hospitals · Dallas, TX
OwnershipVoluntary non-profit - Other
CMS Certification Number670049
Location9301 North Central Expressway Suite 100Dallas, TX 75231 · Dallas County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75251 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
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$71.28 typical visit price
range $18.48 – $141.20
Typical copayment $17.82 (range $4.62 – $35.30)
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.

71.17/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.94
Promoting Interoperability90
Improvement Activities40
Cost48.29

Reported Quality Measures

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
100%89 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
85%1,829 patients4/55-star benchmark: 100%
e-Prescribing
96%553 patients3/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
72%357 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
86%1,154 patients4/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
21%1,597 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 93% · 557 patients
Patients screened: 95% · 557 patients
57%23 patients3/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
89%957 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
76%111 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.

Other Providers at the Same Location NPPES 4

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

DR. IRENE ARROYO DPM
Podiatrist (Primary Podiatric Medicine)
12221 MERIT DR STE 280
DALLAS, TX 75251
Dallas County (972) 853-7100
INTERVENTIONAL PARTNERS PLLC
Durable Medical Equipment & Medical Supplies
12221 MERIT DR STE 280
DALLAS, TX 75251
Dallas County (972) 853-7100
DR. JOEL W BROOK D.P.M.
Podiatrist
12221 MERIT DR STE 280
DALLAS, TX 75251
Dallas County (972) 853-7100
KEVIN OSHIOKPEKHAI DPM
Podiatrist (Foot & Ankle Surgery)
12221 MERIT DR STE 280
DALLAS, TX 75251
Dallas County (972) 544-9725

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 Sonia Simon's NPI number?

The NPI number for Sonia Simon is 1902460009. It was assigned to this individual provider in the NPPES registry on April 24, 2019.

Where is Sonia Simon located?

Sonia Simon practices at 12221 Merit Dr Ste 280, Dallas, TX 75251. The listed phone number is (972) 853-7100.

What is Sonia Simon's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Sonia Simon enrolled in Medicare?

Yes. Sonia 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 Sonia Simon accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 6 other insurers list Sonia 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 Sonia Simon affiliated with any hospitals?

According to CMS data, Sonia Simon is affiliated with North Central Surgical Center LLP.

When was this NPI record last updated?

The NPPES record for Sonia Simon was last updated on July 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.