Michael Simon, M.D.
NPI 1366896912 · Pulmonary Disease Physician · Fall River, MA
Enrolled with Medicare as Practitioner - Pulmonary Disease · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Michael Simon, M.D. is a Pulmonary Disease Physician provider in Fall River, MA (NPI 1366896912).
Provider details
- NPI number
- 1366896912
- Entity type
- Individual
- Primary specialty
- Pulmonary Disease PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- LP04894 (RI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
10 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)25% of score
1,020 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With High Level of Medical Decision Making, If Using Time, 40 Minutes Or More99215 | 171 | $180 |
| Critical Care, First 30-74 Minutes99291 | 143 | $209 |
| Visit Complexity Inherent to Evaluation and Management Associated With Medical Care Services That Serve As the Continuing Focal Point for All Needed Health Care Services And/Or With Medical Care Services That Are Part of Ongoing Care Related to a Patient'SG2211 | 112 | $16 |
| New Patient Office Or Other Outpatient Visit With a High Level of Medical Decision Making, If Using Time, 60 Minutes Or More99205 | 102 | $221 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 85 | $130 |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 27 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Albuterol Sulfatebrand: Albuterol Sulfate Hfa | 234 | 108 |
| Fluticasone/Umeclidin/Vilanterbrand: Trelegy Ellipta | 113 | 29 |
| Fluticasone/Vilanterolbrand: Breo Ellipta | 104 | 17 |
| Montelukast Sodium | 97 | 34 |
| Albuterol Sulfatebrand: Ventolin Hfa | 94 | 31 |
| Prednisone | 93 | 61 |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$27 across 1 record (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Additional practice locations (1)
- 593 Eddy StProvidence, RI 02903-4923Phone: (401) 444-8410Fax: (401) 444-5914
Registry dates
- Enumerated
- 2016-04-20
- Last updated
- 2025-01-22
- Certified
- 2025-01-22
Frequently asked questions
- What is Michael Simon's NPI number?
- Michael Simon's National Provider Identifier (NPI) is 1366896912, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Michael Simon's specialty?
- Michael Simon is listed in the NPPES registry with a primary specialty of Pulmonary Disease Physician (Allopathic & Osteopathic Physicians).
- Where is Michael Simon located?
- Michael Simon's practice location on file with NPPES is 1030 President Ave Ste 210, Fall River, MA 02720-5928.
- What is Michael Simon's phone number?
- The practice phone number listed in the NPPES registry for Michael Simon is (508) 973-1780.
- Does Michael Simon accept Medicare?
- Michael Simon is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Michael Simon's NPI active?
- Yes — Michael Simon's NPI (1366896912) is active in the NPPES registry as of the last update on 2025-01-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.