Individual provider Active NPI

Gary S. Simon, M.D.

  • Orthopaedic Surgery Physician
  • Austell, GA
National Provider Identifier
1467440107
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
040235 Issued in GA
Practice address
2041 Mesa Valley Way
Suite 100
Austell, GA 30106-8157
Phone
(770) 944-1100
Fax
(770) 944-6469
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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 040235 GA Primary

Addresses

Primary practice location

2041 Mesa Valley Way
Suite 100
Austell, GA 30106-8157

Mailing address

2041 Mesa Valley Way
Suite 100
Austell, GA 30106-8157
Phone (770) 944-1100

Other identifiers 4

IdentifierTypeStateIssuer
000666311HMedicaidGA
000666311IMedicaidGA
000666311CMedicaidGA
000666311GMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20081111000854 GA Practitioner - Orthopedic Surgery 1052470630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
State University of New York Downstate Medical Center, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

1285 Hembree Rd
200A
Roswell, GA 30076-4995
Phone (770) 475-2710

1336 Hwy 54 W
BLDG 400 Suite C
Fayetteville, GA 30214-4574
Phone (770) 461-6142

2041 Mesa Valley Way
Suite 100
Austell, GA 30106-6856

270 Chastain NWRD
Kennesaw, GA 30144-3012
Phone (770) 421-8005

4441 Atlanta Rd SE
Suite 207
Smyrna, GA 30080-6442
Phone (770) 944-1100

5671 Peachtree Dunwoody Rd
Suite 900
Atlanta, GA 30342-5022

5671 Peachtree Dunwoody Rd NE
Suite 900 950
Atlanta, GA 30342-5022
Phone (404) 847-9999

655 Molly LN
Suite 100
Woodstock, GA 30189-6519
Phone (770) 517-1080

8509 Hospital Dr
Douglasville, GA 30134-2414
Phone (770) 947-5440

Hospital & facility affiliations

  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC Orthopaedic Surgery CurrentSince Jul 1, 1999 Accepting new patients
Resurgens, LLC Orthopaedic Surgery CurrentSince Jul 1, 1999 Accepting new patients

Locations

2041 Mesa Valley Way
Ste 100
Austell, GA 30106
Phone (770) 944-1100

6001 Professional Pkwy
Ste 1040
Douglasville, GA 30134
Phone (770) 489-3513

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

4441 Atlanta Rd SE
Ste 207
Smyrna, GA 30080
Phone (770) 423-2180

2230 Towne Lake Pkwy
Bldg 300
Woodstock, GA 30189
Phone (770) 517-1900

Interoperability endpoints

  • Direct secure messaging: gary.simon.1@15749.direct.athenahealth.com

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 4

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1467440107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 MESA VALLEY WAY",
            "address_2": "SUITE 100",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068157",
            "telephone_number": "770-944-1100",
            "fax_number": "770-944-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 MESA VALLEY WAY",
            "address_2": "SUITE 100",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068157",
            "telephone_number": "770-944-1100",
            "fax_number": "770-944-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "GARY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "040235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000666311H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000666311I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000666311C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000666311G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.