DR. LISA KANTZ SIMONS M.D.
NPI 1649475377
Pediatrics - Adolescent Medicine in Chicago, IL

NPI Status: Active since June 21, 2007

Contact Information

225 E CHICAGO AVE # MS 161B
CHICAGO, IL
ZIP 60611
Phone: (312) 227-6800
Fax: (312) 227-9446

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  • Individual
  • Female
  • Years of Experience 19
  • Pediatrics
  • Adolescent Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About LISA SIMONS

This page provides the complete NPI Profile along with additional information for Lisa Simons, a pediatrician established in Chicago, Illinois with a medical specialization in Pediatrics, focusing in adolescent medicine and more than 19 years of experience. The healthcare provider is registered in the NPI registry with number 1649475377 assigned on June 2007. The practitioner's primary taxonomy code is 2080A0000X with license number 036.133606 (IL). The provider is registered as an individual and her NPI record was last updated 10 years ago.

NPI
1649475377
Provider Name
DR. LISA KANTZ SIMONS M.D.
Gender
Female
Entity Type
Individual
Location Address
225 E CHICAGO AVE # MS 161B CHICAGO, IL 60611
Location Phone
(312) 227-6800
Location Fax
(312) 227-9446
Mailing Address
225 E CHICAGO AVE # MS 161 APT 205 CHICAGO, IL 60611
Mailing Phone
(312) 227-6800
Mailing Fax
(312) 227-9446
Medical School Name
OTHER
Graduation Year
2007
Is Sole Proprietor?
Yes
Enumeration Date
06-21-2007
Last Update Date
04-02-2015
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A pediatrician like Lisa Simons is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

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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

Pediatrics Adolescent Medicine

Taxonomy Code
2080A0000X
Type
Allopathic & Osteopathic Physicians
License No.
036.133606
License State
IL
Taxonomy Description
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

Insurance Plans Accepted

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

  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - PPO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - PPO

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

Medicare Participation & PECOS Enrollment Status

Lisa 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.

Lisa 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: 9931369030

    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: I20160713000452

    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

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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.
1649475377
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
26898710314
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 8 + 9 + 8 + 7 + 1 + 0 + 3 + 1 + 4 + 24 = 73
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 73 = 77

The NPI number 1649475377 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1649475377, enumerated in the NPI registry as an "individual" on June 21, 2007

The provider is located at 225 E Chicago Ave # Ms 161b Chicago, Il 60611 and the phone number is (312) 227-6800

The provider's speciality is Pediatrics with taxonomy code 2080A0000X with a focus in Adolescent Medicine

The provider has more than 19 years of experience.

The provider might be accepting Accepts: Aetna CVS Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 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.

This NPI record was last updated on June 21, 2007. 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.