Individual provider Active NPI

Gregory Joseph Simmons, M.D.

  • Orthopaedic Surgery Physician
  • Belleville, IL
National Provider Identifier
1194729871
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036102208 Issued in IL
Practice address
4700 Memorial Dr
Ste 340
Belleville, IL 62226-5370
Phone
(618) 234-9884
Fax
(618) 235-9020
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036102208 IL Primary

Addresses

Primary practice location

4700 Memorial Dr
Ste 340
Belleville, IL 62226-5370

Mailing address

4700 Memorial Dr
Ste 340
Belleville, IL 62226-5370
Phone (618) 234-9884

Other identifiers 2

IdentifierTypeStateIssuer
036102208MedicaidIL
1194729871MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040129000064 IL Practitioner - Orthopedic Surgery 9830092865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Saint Louis University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

1404 Cross St
Shiloh, IL 62269-2988
Phone (618) 607-3055

1418 Cross St
Suite 350
Shiloh, IL 62269-2988
Phone (618) 607-3900

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-6220

4700 Memorial Dr
Belleville, IL 62226-5373

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement11
Knee replacement20
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036102208ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory J Simmons Orthopedic Surgery LLC PastSince Nov 24, 2003 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gsimmons170944@direct.carenet.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1194729871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 MEMORIAL DR",
            "address_2": "STE 340",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265370",
            "telephone_number": "618-234-9884",
            "fax_number": "618-235-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 MEMORIAL DR",
            "address_2": "STE 340",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265370",
            "telephone_number": "618-234-9884",
            "fax_number": "618-235-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "GREGORY",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036102208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102208",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194729871",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4700 Memorial Dr",
            "address_2": "Ste 340",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.