Active NPI
Donovan Mitchell Simmons, M.D.
- Family Medicine Physician
- Austin, TX
National Provider Identifier
1922068733
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jun 20, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- L6180
- Practice address
- 12221 N Mo Pac Expy
Austin, TX 78758-2401 - Phone
- (512) 306-1903
- Fax
- (512) 306-0107
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | L6180 | TX | Primary |
Addresses
Primary practice location
12221 N Mo Pac Expy
Austin, TX 78758-2401
Mailing address
PO Box 4268
Austin, TX 78765-4268
Phone (512) 306-1903
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 158085405 | Medicaid | TX | |
| P00935759 | Other | TX | RRMCARE THRU HCMS |
| 10046385 | Other | TX | AMERIGROUP |
| 158085406 | Medicaid | TX | |
| 8V0511 | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hill Country Monitoring LLC | Past | Accepting new patients | |
| Hill Country Monitoring LLC | Past | Accepting new patients | |
| Sunil Reddy Cheruku, MD, PA | Past | Accepting new patients | |
| Hyperbaric Medicine Consultants PA | Past | Accepting new patients | |
| Chestnut Hill Emergency Associates LTD | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Neurological Surgery Physician
- Austin, TX
- NPI 1538351267
-
- Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
- Austin, TX
- NPI 1942296199
-
- Internal Medicine Physician
- Austin, TX
- NPI 1013063817
-
- Emergency Medicine Physician
- Philadelphia, PA
- NPI 1588628176
-
- Neurological Surgery Physician
- Jackson, MS
- NPI 1750759163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430179200000",
"number": "1922068733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4268",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787654268",
"telephone_number": "512-306-1903",
"fax_number": "512-306-0107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12221 N MO PAC EXPY",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787582401",
"telephone_number": "512-306-1903",
"fax_number": "512-306-0107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "DONOVAN",
"middle_name": "MITCHELL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2015-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "L6180",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "158085405",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RRMCARE THRU HCMS",
"identifier": "P00935759",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10046385",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "158085406",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8V0511",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.