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DR. ANTHONY SIMMS II M.D.
NPI 1972815785
Pathology - Anatomic Pathology & Clinical Pathology in Riverdale, GA

Active since July 09, 2010PECOS EnrolledAccepts Medicare Assignment
11 UPPER RIVERDALE RD SW, PATHOLOGY DEPT, RIVERDALE, GA 30274(678) 423-1550 Get Directions Write a Review

NPPES record last updated: July 23, 2015. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Dr. Anthony Simms Ii M.d. NPPES

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

DR. ANTHONY SIMMS II M.D. (NPI 1972815785) is an individual anatomic pathology & clinical pathology provider in Riverdale, Georgia, licensed in Georgia (71636) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS, is affiliated with Gerald Champion Regional Medical Center, and is a graduate of Meharry Medical College School Of Medicine (2009).

NPPES Registry Identity

NPI1972815785
Entity TypeIndividualMale
Primary Taxonomy207ZP0102X
Provider Legal NameDR. ANTHONY SIMMS IICredential: M.D.
Location Address11 UPPER RIVERDALE RD SW, PATHOLOGY DEPTRiverdale, GA 30274-2615
Mailing Address11 Upper Riverdale Rd Sw, Pathology DeptRiverdale, GA 30274-2615 · (678) 423-1550
Phone(678) 423-1550
Sole ProprietorNo
Medical School CMSMeharry Medical College School Of MedicineGraduated 2009
Enumeration DateJuly 9, 2010
Last NPPES UpdateJuly 23, 2015
✔ NPI 1972815785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in GA · 71636
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
11 UPPER RIVERDALE RD SW, Riverdale, GA 30274
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Harbor Health, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Anthony Simms Ii 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 ID7012226731
PECOS Enrollment IDI20190313000153
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.

Medicare Billing Reassignments

4

Medicare enrollment records show Anthony Simms reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

New York University
548 mi
Cardiovascular Disease
3301 QUANTUM BLVD
Boynton Beach, FL 33426
  • Reassigned Medicare billing, New York enrollment
  • 7,712 clinicians in this Medicare group
NPI 1285826438 (877) 648-2964
Texas Digestive Disease Consultants, PLLC
701 mi
Gastroenterology
4100 S SHEPHERD DR
Houston, TX 77098
  • Reassigned Medicare billing, Texas enrollment
  • 575 clinicians in this Medicare group
NPI 1013429968 (832) 255-5681
Propath Associates, PLLC
724 mi
Anatomic Pathology & Clinical Pathology
1355 RIVER BEND DR
Dallas, TX 75247
  • Reassigned Medicare billing, Texas enrollment
  • 77 clinicians in this Medicare group
NPI 1902885890 (214) 638-2000
Austin Pathology Associates
811 mi
Anatomic Pathology & Clinical Pathology
12221 N MOPAC EXPY
Austin, TX 78758
  • Reassigned Medicare billing, Texas enrollment
  • 107 clinicians in this Medicare group
NPI 1669414330 (512) 901-1215

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
164 services84 patients
Special stained specimen slides to examine tissue, each additional procedure 88341
Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.
65 services21 patients
Special stained specimen slides to examine tissue, initial procedure 88342
This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.
43 services38 patients
Pathology examination of tissue using a microscope, moderately low complexity 88304
A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.
35 services25 patients
Cell examination of specimen, selective cellular enhancement technique 88112
Cell examination of a specimen using selective cellular enhancement technique is a lab process that improves the visibility of certain cells in a sample. It helps in identifying abnormalities or diseases. The process is non-invasive, safe, and aids in accurate diagnosis.
19 services17 patients

Hospital Affiliations CMS Care Compare 4

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

Gerald Champion Regional Medical Center

Acute Care Hospitals · Alamogordo, NM
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320004
Location2669 Scenic DriveAlamogordo, NM 88310 · Otero County
Emergency services Birthing friendly

Dallas Medical Center

Acute Care Hospitals · Dallas, TX
OwnershipProprietary
CMS Certification Number450379
Location7 Medical ParkwayDallas, TX 75234 · Dallas County
Emergency services

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

Baylor Scott And White Medical Center Sunnyvale

Acute Care Hospitals · Sunnyvale, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number670060
Location231 South Collins RoadSunnyvale, TX 75182 · Dallas County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30274 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

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.

KAREN KRECHMERY NP
Nurse Practitioner
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 994-9326
GEORGIA HOSPITALISTS GROUP, LLC
Hospitalist
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 991-8000
SOUTHERN REGIONAL PHYSICIANS MANAGEMENT GROUP, LLC
Surgery
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 991-8000
HARMONY GROVE EMERGENCY PHYSICIANS LLC
Emergency Medicine
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (973) 251-1132
DR. NANCY ELIZABETH NEWTON M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 991-8615
DR. LILIAN OMO ODION-OMONHIMIN MD
Student in an Organized Health Care Education/Training Program
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 991-8026
NATASHA SMITH MD
Emergency Medicine
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 994-9326
SOUTH SOUND INPATIENT PHYSICIANS, PLLC
Hospitalist
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 991-8000

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 Anthony Simms's NPI number?

The NPI number for Anthony Simms is 1972815785. It was assigned to this individual provider in the NPPES registry on July 9, 2010.

Where is Anthony Simms located?

Anthony Simms practices at 11 Upper Riverdale Rd SW Pathology Dept, Riverdale, GA 30274. The listed phone number is (678) 423-1550.

What is Anthony Simms's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Anthony Simms enrolled in Medicare?

Yes. Anthony Simms 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.

Which organizations bill Medicare for Anthony Simms's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Anthony Simms reassigns Medicare benefits to 4 organizations: New York University (Boynton Beach, FL), Texas Digestive Disease Consultants, PLLC (Houston, TX), Propath Associates, PLLC (Dallas, TX) and Austin Pathology Associates (Austin, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Anthony Simms's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Anthony Simms accept?

Health plans from Blue Cross and Blue Shield of Texas, Harbor Health, Molina Healthcare, Oscar Insurance Company and Sendero Health Plans, Local Nonprofit list Anthony Simms 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 Anthony Simms affiliated with any hospitals?

According to CMS data, Anthony Simms is affiliated with Gerald Champion Regional Medical Center, Dallas Medical Center, North Central Surgical Center LLP and Baylor Scott And White Medical Center Sunnyvale.

When was this NPI record last updated?

The NPPES record for Anthony Simms was last updated on July 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.