DR. SIMEON H. WALL SR. M.D.
NPI 1700939147
Specialist in Shreveport, LA
NPI Status: Active since January 19, 2007
Contact Information
8600 FERN AVE
SHREVEPORT, LA
ZIP 71105
Phone: (318) 795-0801
Fax: (318) 795-9492
- Individual
- Male
- Specialist
- PECOS Enrolled
- Opted-Out Medicare
About SIMEON WALL
This page provides the complete NPI Profile along with additional information for Simeon Wall, a provider established in Shreveport, Louisiana with a medical specialization in Specialist. The healthcare provider is registered in the NPI registry with number 1700939147 assigned on January 2007. The practitioner's primary taxonomy code is 174400000X with license number 02970R (LA). The provider is registered as an individual and his NPI record was last updated 13 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization.
- NPI
- 1700939147
- Provider Name
- DR. SIMEON H. WALL SR. M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 8600 FERN AVE SHREVEPORT, LA 71105
- Location Phone
- (318) 795-0801
- Location Fax
- (318) 795-9492
- Mailing Address
- 8600 FERN AVE SHREVEPORT, LA 71105
- Mailing Phone
- (318) 795-0801
- Mailing Fax
- (318) 795-9492
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 01-19-2007
- Last Update Date
- 02-22-2012
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Simeon Wall opted out of Medicare effective on 09-29-2016 until 09-29-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
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
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- 02970R
- License State
- LA
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5L694 | MEDICARE ID-TYPE UNSPECIFIED (04) | LA | PLASTIC SURGERY |
| B61438 | MEDICARE UPIN (02) | LA |
Medicare Participation & PECOS Enrollment Status
Simeon Wall 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
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 09-29-2016
Opt-Out End Date: 09-29-2026
Eligible to Order and Refer? Yes
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
Reviews for DR. SIMEON H. WALL SR. M.D.
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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. | |||||||||
| 1 | 7 | 0 | 0 | 9 | 3 | 9 | 1 | 4 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 0 | 0 | 18 | 3 | 18 | 1 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 0 + 0 + 1 + 8 + 3 + 1 + 8 + 1 + 8 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1700939147 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1992059968 | SIMEON H. WALL, MD A PROFESSIONAL MEDICAL CORP Organization | Plastic Surgery | 8600 FERN AVE SHREVEPORT, LA 71105 (318) 795-0801 |
| 1245229624 | HOLLY CASEY WALL MD, FACS Individual | Surgery (Plastic and Reconstructive Surgery) | 8600 FERN AVE SHREVEPORT, LA 71105 (318) 795-0801 |
| 1275522682 | SIMEON WALL JR. MD, FACS Individual | Surgery (Plastic and Reconstructive Surgery) | 8600 FERN AVE SHREVEPORT, LA 71105 (318) 795-0801 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1700939147, enumerated in the NPI registry as an "individual" on January 19, 2007
The provider is located at 8600 Fern Ave Shreveport, La 71105 and the phone number is (318) 795-0801
The provider's speciality is Specialist with taxonomy code 174400000X
The provider might be accepting Accepts: Medicare and Medicaid. 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.
No, the provider signed an affidavit on September 29, 2016 to opt-out of the Medicare program. The provider is excluded from the Medicare program until September 29, 2026.
This NPI record was last updated on January 19, 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].
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