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DR. PHILIP MICHAEL SIMONE MD
NPI 1952372468
Family Medicine in Matawan, NJ

Active since February 01, 2006PECOS EnrolledAccepts Medicare Assignment
746 HIGHWAY 34, SUITE 2, MATAWAN, NJ 07747(732) 290-8300(732) 290-8301 Get Directions Write a Review

NPPES record last updated: August 21, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Philip Michael Simone Md NPPES

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

DR. PHILIP MICHAEL SIMONE MD (NPI 1952372468) is an individual family medicine provider in Matawan, New Jersey, licensed in New Jersey (MA70752) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Bayshore Medical Center, and is a graduate of Rutgers R W Johnson Medical School (cam/new Bruns/pisc) (1997).

NPPES Registry Identity

NPI1952372468
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. PHILIP MICHAEL SIMONECredential: MD
Location Address746 HIGHWAY 34, SUITE 2Matawan, NJ 07747
Mailing Address746 Highway 34, Suite 2Matawan, NJ 07747 · (732) 290-8300 · Fax (732) 290-8301
Phone(732) 290-8300
Fax(732) 290-8301
Sole ProprietorNo
Medical School CMSRutgers R W Johnson Medical School (cam/new Bruns/pisc)Graduated 1997
Enumeration DateFebruary 1, 2006
Last NPPES UpdateAugust 21, 2008
✔ NPI 1952372468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NJ · MA70752
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.
746 HIGHWAY 34, Matawan, NJ 07747
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Other Identifiers 14

Other57362Qualcare
Other434935Aetna Hmo
Medicare PIN111362
OtherP2547228Oxford
Other7370258Aetna
OtherK9946Horizon Blue Cross/blue Shield
Other000009194474Phcs
Other00002095299 09United Healthcare
Other8734731013Cigna Hmo/pos
Other8734731P03Cigna Open Access Plus
Other3K6303-975476Healthnet Advantage Platinum Ppo
Medicare UPINH21438NJ
Other5528995First Health
Other3K6306Healthnet Advantage Platinum

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. Philip Michael Simone 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 ID5597864009
PECOS Enrollment IDI20070625000484
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.
233 services115 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.
106 services78 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.
101 services101 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.
17 services17 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.
16 services16 patients

Hospital Affiliations CMS Care Compare

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

Bayshore Medical Center

Acute Care Hospitals · Holmdel, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310112
Location727 N Beers StHolmdel, NJ 07733 · Monmouth County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07747 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
$94.90 typical visit price
range $61.59 – $185.05
Typical copayment $23.72 (range $15.39 – $46.26)
Most-billed visit code 99203
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers16 claims38 services$5.22 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 11

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

CENTER FOR MARRIAGE & FAMILY THERAPY, P.C.
Marriage & Family Therapist
746 HIGHWAY 34, SUITE 3
MATAWAN, NJ 07747
Monmouth County (732) 264-8878
MS. KAREN SPILER MSW
Marriage & Family Therapist
746 HIGHWAY 34, SUITE 3
MATAWAN, NJ 07747
Monmouth County (732) 264-8878
MS. VICKI GILMAN MSW
Social Worker (Clinical)
746 HIGHWAY 34, SUITE 3
MATAWAN, NJ 07747
Monmouth County (732) 264-8878
MS. MERYL GOLDBERG MSW
Social Worker (Clinical)
746 HIGHWAY 34, STE 3
MATAWAN, NJ 07747
Monmouth County (732) 264-8878
CINDY PANEK MSW LCSW
Social Worker (Clinical)
746 HIGHWAY 34, SUITE 3
MATAWAN, NJ 07747
Monmouth County (732) 264-8878
MS. JACALYN HELD MSW
Marriage & Family Therapist
746 HIGHWAY 34, SUITE 3
MATAWAN, NJ 07747
Monmouth County (732) 264-8878
LISA GOLDBERG LSCW
Social Worker (Clinical)
746 HIGHWAY 34, SUITE 3
MATAWAN, NJ 07747
Monmouth County (732) 264-8878
RACHEL ROBINSON MSW LCSW
Social Worker (Clinical)
746 HIGHWAY 34, SUITE 3
MATAWAN, NJ 07747
Monmouth County (732) 264-8878

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 Philip Simone's NPI number?

The NPI number for Philip Simone is 1952372468. It was assigned to this individual provider in the NPPES registry on February 1, 2006.

Where is Philip Simone located?

Philip Simone practices at 746 Highway 34 Suite 2, Matawan, NJ 07747. The listed phone number is (732) 290-8300.

What is Philip Simone's specialty?

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

Is Philip Simone enrolled in Medicare?

Yes. Philip Simone 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.

Is Philip Simone affiliated with any hospitals?

According to CMS data, Philip Simone is affiliated with Bayshore Medical Center.

When was this NPI record last updated?

The NPPES record for Philip Simone was last updated on August 21, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.