RICHARD A SIMMONS D.O.
NPI 1902800865
Family Medicine in Columbiana, OH

NPI Status: Active since June 09, 2005

Contact Information

107 ROYAL BIRKDALE DR STE A
COLUMBIANA, OH
ZIP 44408
Phone: (330) 482-9350
Fax: (330) 482-2336

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  • Individual
  • Male
  • Family Medicine
  • Accepts Insurance
  • PECOS Enrolled

About RICHARD SIMMONS

This page provides the complete NPI Profile along with additional information for Richard Simmons, a primary care provider established in Columbiana, Ohio with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1902800865 assigned on June 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 34-004874 (OH). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1902800865
Provider Name
RICHARD A SIMMONS D.O.
Gender
Male
Entity Type
Individual
Location Address
107 ROYAL BIRKDALE DR STE A COLUMBIANA, OH 44408
Location Phone
(330) 482-9350
Location Fax
(330) 482-2336
Mailing Address
9471 MARKET ST SUITE B NORTH LIMA, OH 44452
Mailing Phone
(330) 729-2388
Mailing Fax
(330) 482-2336
Is Sole Proprietor?
No
Enumeration Date
06-09-2005
Last Update Date
08-16-2018
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A primary care provider (PCP) like Richard Simmons sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
34-004874
License State
OH
Taxonomy Description
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.

Insurance Plans Accepted

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

  • Bronze First 7500 $25 Generic Drugs - HMO
  • Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Gold 1500 $15 Generic Drugs - HMO
  • Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Select Drugs - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Low Premium Silver 6000 $3 Generic Drugs - HMO
  • Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
  • Silver 5000 $20 Generic Drugs - HMO
  • Silver 5000 $20 Generic Drugs Adult Vision & Fitness - HMO

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
0823774MEDICAID (05)OH 

Medicare Participation & PECOS Enrollment Status

Richard Simmons 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

  • 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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    8 DME suppliers used 32 Medicare Claims 63 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    5 DME suppliers used 11 Medicare Claims 20 Services Paid

Drugs Administered Through DME

  • DME-Drugs Administered Through DME (DG006N)

    Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms (HCPCS:J7605)

    1 DME suppliers used 11 Medicare Claims 660 Services Paid

  • DME-Drugs Administered Through DME (DG000N)

    Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)

    1 DME suppliers used 11 Medicare Claims 660 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram (HCPCS:J7644)

    1 DME suppliers used 11 Medicare Claims 330 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 55 times for 48 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 147 times for 122 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 13 times for 12 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 44408 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.72
  • Minimum New Patient Price $54.34
  • Maximum New Patient Price $166.65
  • Average New Patient Copayment $21.18
  • Minimum New Patient Copayment $13.58
  • Maximum New Patient Copayment $41.66

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $96.44
  • Minimum Established Patient Price $17.1
  • Maximum Established Patient Price $135.4
  • Average Established Patient Copayment $24.11
  • Minimum Established Patient Copayment $4.27
  • Maximum Established Patient Copayment $33.85

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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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.
1902800865
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
29021600812
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 0 + 2 + 1 + 6 + 0 + 0 + 8 + 1 + 2 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1902800865 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 9 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1093710808 DAVID NICHOLAS BAER DPM
Individual
Podiatrist (Primary Podiatric Medicine)107 ROYAL BIRKDALE DR STE A
COLUMBIANA, OH 44408
(330) 482-9350
1467456319 THOMAS R TIMKO M.D.
Individual
Internal Medicine107 ROYAL BIRKDALE DR STE A
COLUMBIANA, OH 44408
(330) 482-9350
1871586040MS. LORI JEAN GRENICH MS, MSN, RN, CNP
Individual
Nurse Practitioner (Adult Health)107 ROYAL BIRKDALE DR STE A
COLUMBIANA, OH 44408
(330) 482-9350
1326453010 MATTHEW MICHAEL NARDUCCI DPM
Individual
Podiatrist (Primary Podiatric Medicine)107 ROYAL BIRKDALE DR STE A
COLUMBIANA, OH 44408
(330) 482-9350
1104304260MERCY HEALTH PHYSICIANS YOUNGSTOWN LLC
Organization
Durable Medical Equipment & Medical Supplies107 ROYAL BIRKDALE DR STE A
COLUMBIANA, OH 44408
(330) 482-9350
1063174308MERCY HEALTH PHYSICIANS YOUNGSTOWN SPECIALTY CARE LLC
Organization
Durable Medical Equipment & Medical Supplies (Customized Equipment)107 ROYAL BIRKDALE DR STE A
COLUMBIANA, OH 44408
(330) 482-9350
1043669476MR. WYNAND NEL MD
Individual
Family Medicine107 ROYAL BIRKDALE DR STE A
COLUMBIANA, OH 44408
(330) 482-9350
1548757685 BRIAN SANCHEZ MD
Individual
Family Medicine107 ROYAL BIRKDALE DR STE A
COLUMBIANA, OH 44408
(330) 482-9350
1003194739 JOHN ALEX HEINTZELMAN M.D.
Individual
Family Medicine107 ROYAL BIRKDALE DR STE A
COLUMBIANA, OH 44408
(330) 482-9350

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1902800865, enumerated in the NPI registry as an "individual" on June 09, 2005

The provider is located at 107 Royal Birkdale Dr Ste A Columbiana, Oh 44408 and the phone number is (330) 482-9350

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider might be accepting Accepts: CareSource, 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.

Medicare beneficiaries should expect a typical cost of $84.72 with an average copayment of $21.18 for new patient appointments. Established patients should expect a typical charge of $96.44 and an average copayment of 24.11. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes and Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report.

This NPI record was last updated on June 09, 2005. 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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