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NPI 1851394936 · New Hyde Park, NY · Specialist
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Simon Hall is a specialist provider located in New Hyde Park, New York. This profile covers 21 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Simon Hall |
| Address | 450 Lakeville Rd |
| City | New Hyde Park |
| State | NY |
| ZIP | 11042 |
| Taxonomy | Specialist |
| NPI Enumerated | May 23, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $160.4K |
| Medicaid | $3.5K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 660 | $80 | $50.8K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 360 | $50 | $17K |
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 90 | $150 | $13.3K |
| 52000 | In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a… | 190 | $70 | $13.2K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 90 | $120 | $10.3K |
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 110 | $90 | $9.9K |
| 52601 | During transurethral resection of the prostate (TURP), the surgeon inserts a resectoscope via the urethra and removes a portion of the prostate. This procedure includes several other urological… | 10 | $680 | $8.9K |
| 52235 | The provider inspects the urethra, prostatic urethra (in men), the interior of the bladder, and ureteric openings using a cystoscope passed through the urethra and into the bladder; he destroys… | 30 | $260 | $6.9K |
| 52234 | The provider inspects the urethra, prostatic urethra (in men), the interior of the bladder, and ureteric openings using a cystoscope passed through the urethra and into the bladder; he destroys… | 30 | $200 | $5.8K |
| 52356 | The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into… | 10 | $360 | $4.3K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99214 | 15,609 | 30,450 | 90 | $100 | $19K |
| 52000 | 40 | 620 | 60 | $170 | $14.3K |
| 99213 | 1,500 | 31,440 | 80 | $70 | $12.1K |
| 52601 | 21 | 40 | 10 | $710 | $11.4K |
| 52356 | 122 | 140 | 20 | $450 | $9.5K |
| 52235 | 7 | 30 | 20 | $390 | $8.6K |
| 52234 | 6 | 30 | 20 | $370 | $7.7K |
| 76872 | 275 | 300 | 30 | $110 | $6.9K |
| 99204 | 1,975 | 14,170 | 30 | $130 | $6.6K |
| 55700 | 90 | 230 | 20 | $190 | $6.3K |
Showing 1–10 of 21
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 150 | $20 | $3.5K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care… | 40 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 11,949 | 19,110 | 360 | $70 | $321K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care… | 909 | 1,600 | 50 | $10 | $1.2K |
Other providers in the same ZIP code as Simon Hall, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Freedom Care LLC | NY | Home Health Agency | $0 | $3B |
| Northwell Health Laboratories | NY | Clinical Medical Laboratory | $48.5M | $198.2M |
| Optum Medical Care Of New Jersey PC | NY | Pediatrics Physician | $0 | $219.4M |
| North Shore University Hospital | NY | Case Management Agency | $0 | $166.6M |
| Prohealth Care Associates LLP | NY | Internal Medicine Physician | $0 | $69.4M |
| Personal Touch Home Care Of New York, Inc. | NY | Early Intervention Provider Agency | $0 | $19.3M |
| Nhpe, LLC | NY | Ambulatory Surgical Clinic/Center | $831.7K | $3M |
| Stuart Weinerman | NY | Endocrinology, Diabetes & Metabolism Physician | $2.3M | $2.3K |
| Jason Karp | NY | Pulmonary Disease Physician | $2.1M | $35.2K |
| Vishesh Agrawal | NY | Radiation Oncology Physician | $2.1M | $13K |
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