Kelly K. Simone, PA
Individual provider Active NPI Physician Assistant · Powell, WY
NPI 1770529703 · NPPES record last updated May 29, 2024
Key facts
- NPI
- 1770529703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA313 (WY)
- Practice address
- 777 Avenue H
Powell, WY 82435-2260 - Phone
- (307) 754-2267
- NPI assigned
- Jun 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West Park Hospital District
Billings Clinic
Practice addresses (Care Compare)
424 Yellowstone Ave
Cody, WY 82414-9309
Phone (307) 527-7501
707 Sheridan Ave
Cody, WY 82414-3409
Phone (307) 527-7561
Hospital & facility affiliations
- Powell Valley Hospital
- Cody Regional Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.54 of 100
- Quality
- 71.68
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.14
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060224000165 | WY | Practitioner - Physician Assistant | 8921014283 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 313 | WY | MD | Registered Respiratory Therapist |
| PA313 | WY | MD | Physician Assistant |
Practice roles (5 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Billings Clinic | Current |
Accepting new patients | |
| Powell Valley Healthcare Inc | Current |
Accepting new patients | |
| Billings Clinic | Physician Assistant | Current |
Accepting new patients |
| Powell Valley Health Care Inc | Current |
Accepting new patients | |
| West Park Hospital District | Current |
Accepting new patients |
Locations
424 Yellowstone Ave
Ste 120
Cody, WY 82414
Phone (307) 578-2903
424 Yellowstone Ave
Cody, WY 82414
Phone (307) 578-2903
201 Yellowstone Ave
Cody, WY 82414
Phone (307) 527-7561
707 Sheridan Ave
Cody, WY 82414
Phone (307) 527-7561
450 Mountain View St
Powell, WY 82435
Phone (307) 754-2267
777 Avenue H
Powell, WY 82435
Phone (307) 754-1175
Networks
- Freedom Health HMO Network
Interoperability endpoints
- ksimone4@billingsclinic.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA313 | WY | |
| Physician Assistant | 363A00000X | PA313 | WY | Yes |
Addresses
Primary practice location
777 Avenue H
Powell, WY 82435-2260
Mailing address
777 Avenue H
Powell, WY 82435-2260
Phone (307) 754-2267
Other practice location 1
424 Yellowstone Ave Ste 120
Cody, WY 82414-9311
Phone (307) 578-2903
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106133017 | Medicaid | WY |
Other providers in Powell, WY
- Timothy Scott Seeley
- Ryan Michael Shedd
- Katherine Baxter Shelby
- Shopko Stores Operating Co LLC
- Trisha Meredith Shorb
- Simply Reflective Therapy LLC
- Coltan Slater
- Peter D Sloan
- Sharon Leigh Smith
- Ashton Troy Soloai
All providers in Powell, WY · Physician Assistant in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.