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    OpenPayerNPI Medicare & MedicaidJohn Simon
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    John Simon — Billing Profile & Reimbursement Data

    NPI 1881628683 · West Islip, NY · Surgery Physician

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    John Simon is a surgery physician provider located in West Islip, New York. This profile covers 9 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJohn Simon
    Address580 Union Blvd
    CityWest Islip
    StateNY
    ZIP11795
    TaxonomySurgery Physician
    NPI EnumeratedJuly 10, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$37.6K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    9 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    49505The provider repairs an initial inguinal hernia on a child, five years of age or older. She pushes the hernia back to reduce it.20$570$9.1K
    46930The provider destroys internal hemorrhoids by thermal techniques such as infrared coagulation, cauterization, or radiofrequency.40$180$7.1K
    99203The 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…60$90$5.3K
    99204The 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…30$160$5.1K
    99213The 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…50$80$3.9K
    11404The provider excises a noncancerous lesion, excluding a skin tag, of 3.1 to 4.0 cm in diameter, including margins, from the skin of the trunk, arms, or legs.10$220$2.8K
    99214The 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…20$120$2K
    99231The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…30$50$1.6K
    99212The 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,…10$50$740

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    9 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    9921428,22230,45090$100$19K
    9921320,70331,44080$70$12.1K
    49505255020$520$11.4K
    4693031020$180$6.9K
    992046,52914,17030$130$6.6K
    992033,43411,36030$90$4.7K
    992126,8857,85030$40$3.6K
    992311,9693,70040$40$3.3K
    1140441010$130$1.9K

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with John Simon, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Sergio SokolNYCardiovascular Disease Physician$1.8M$5.7M
    Ankur ShahNYInterventional Cardiology Physician$772K$3.6M
    Shahram HormoziNYInterventional Cardiology Physician$1.1M$221.9K
    Howard HertzNYInternal Medicine Physician$1.1M$7.4K
    Cesare SaponieriNYClinical Cardiac Electrophysiology Physician$899.3K$86.7K
    Amrit ChiluwalNYNeurological Surgery Physician$174.6K$0
    John HansenAZSpecialist$155.2K$0
    Dionisios MihalatosNYCardiovascular Disease Physician$127.6K$0
    Richard NewmanFLNeurology Physician$15.1K$0

    Nearby Providers

    Other providers in the same ZIP code as John Simon, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Good Samaritan Hospital Medical CenterNYGeneral Acute Care Hospital$0$63.3M
    Island Digestive Health Center, LLCNYAmbulatory Surgical Clinic/Center$524.7K$2M
    Matthew StrachovskyNYOphthalmology Physician$1.7M$50
    Atlantic Sc LLCNYAmbulatory Surgical Clinic/Center$869.7K$0
    Abu Muhammad HaqueNYInternal Medicine Physician$398.3K$427.8K
    Sumeet AnandNYInternal Medicine Physician$654.7K$96.2K
    Michael ChuNYSurgery Physician$728.4K$1.3K
    Kavita MariwallaNYMOHS-Micrographic Surgery Physician$727.3K$0
    Philip BeuchertNYDiagnostic Radiology Physician$583.7K$1.7K
    Kimon BekelisNYNeurological Surgery Physician$504.9K$510

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. New York Distribution
    John Simon — 0 of 9 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — New York