Active NPI 1720077530 Individual Practitioner Female Practitioner

Dr. Michelle G Sims , MD

Ophthalmology • Wheaton, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Michelle Sims, MD is a certified Ophthalmology practicing in Wheaton, IL. With approximately 35 years of clinical experience since graduating from Medical College Of Georgia School Of Medicine in 1991, Dr. Sims delivers high-quality medical care to the local community at 2015 N MAIN ST.

Dr. Sims is affiliated with Wheaton Eye Clinic Ltd and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient complete exam of visual system, measurement of corneal curvature and depth of eye, removal of cataract with insertion of lens. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2015 N Main St

Wheaton, IL 601873190

Telephone 6306688250

Fax 6306688916

Associated Practice Facility / Clinic

🏢 Wheaton Eye Clinic Ltd Facility NPI 1801883004

Medicare Profile & Education

Medical School

Medical College Of Georgia School Of Medicine

Graduation Year

1991

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Wheaton, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

35 Yrs +11.5 yrs vs City Avg

City Avg: 23.5 Yrs

State Avg: 31.1 Yrs

Regional Practice Density

22 Specialists

Practicing in Wheaton, IL (954 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

7.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Sims (35 Years) 35 Yrs

Wheaton Specialty Average (23.5 Years) 23.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	628	617	$134.45	$131.49
92136 Measurement of corneal curvature and depth of eye	240	126	$58.17	$40.41
66984 Removal of cataract with insertion of lens	232	128	$575.97	$539.93
99213 Established patient office or other outpatient visit, typically 15 minutes	61	54	$97.20	$96.13
92004 New patient complete exam of visual system	54	54	$159.15	$155.57
92133 Imaging of optic nerve	54	54	$39.55	$36.12
68761 Closure of tear duct opening using plug	49	21	$288.37	$211.37
66821 Removal of recurring cataract in lens capsule using a laser	44	37	$357.73	$327.60
92083 Exam of visual field with extended testing	44	44	$67.52	$66.71
92134 Imaging of retina	43	42	$43.53	$40.76
66821 Removal of recurring cataract in lens capsule using a laser	39	33	$357.73	$352.56
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	21	21	$178.93	$177.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	703	689	$134.36	$132.66
92136 Measurement of corneal curvature and depth of eye	266	142	$58.17	$40.49
66984 Removal of cataract with insertion of lens	254	144	$575.97	$538.03
99213 Established patient office or other outpatient visit, typically 15 minutes	98	86	$97.20	$95.49
92004 New patient complete exam of visual system	70	70	$159.15	$156.74
92083 Exam of visual field with extended testing	67	65	$67.52	$66.16
92134 Imaging of retina	61	61	$43.53	$41.13
92133 Imaging of optic nerve	58	58	$39.55	$36.25
66821 Removal of recurring cataract in lens capsule using a laser	42	34	$392.74	$340.32
66821 Removal of recurring cataract in lens capsule using a laser	40	30	$357.73	$327.78
68761 Closure of tear duct opening using plug	38	18	$304.24	$222.09
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	30	30	$178.93	$176.44
66982 Complex removal of cataract with insertion of prosthetic lens	18	13	$788.84	$728.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	746	728	$134.51	$134.28
66984 Removal of cataract with insertion of lens	281	160	$631.64	$546.22
92136 Measurement of corneal curvature and depth of eye	276	150	$59.44	$42.75
92004 New patient complete exam of visual system	100	100	$160.37	$157.71
92083 Exam of visual field with extended testing	62	59	$67.52	$67.19
92133 Imaging of optic nerve	60	58	$39.55	$37.01
99213 Established patient office or other outpatient visit, typically 15 minutes	59	57	$97.20	$96.97
66821 Removal of recurring cataract in lens capsule using a laser	48	34	$357.73	$330.56
92134 Imaging of retina	48	48	$43.53	$42.48
68761 Closure of tear duct opening using plug	47	21	$290.39	$219.41
66821 Removal of recurring cataract in lens capsule using a laser	45	36	$374.07	$348.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	704	695	$134.38	$135.57
92136 Measurement of corneal curvature and depth of eye	280	151	$59.10	$46.31
66984 Removal of cataract with insertion of lens	255	151	$586.19	$562.14
92004 New patient complete exam of visual system	103	103	$160.33	$158.64
92133 Imaging of optic nerve	75	71	$39.55	$37.53
99213 Established patient office or other outpatient visit, typically 15 minutes	61	58	$97.34	$96.81
92083 Exam of visual field with extended testing	59	56	$67.52	$68.21
68761 Closure of tear duct opening using plug	50	23	$292.03	$223.88
66821 Removal of recurring cataract in lens capsule using a laser	46	31	$357.73	$335.68
92012 Established patient problem focused exam of visual system	45	45	$95.43	$96.39
92134 Imaging of retina	40	38	$43.53	$43.10
66821 Removal of recurring cataract in lens capsule using a laser	31	28	$357.68	$361.68

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	544	535	$133.93	$134.52
66984 Removal of cataract with insertion of lens	218	126	$597.43	$566.13
92136 Measurement of corneal curvature and depth of eye	204	108	$68.50	$50.74
92004 New patient complete exam of visual system	97	97	$159.63	$158.93
92012 Established patient problem focused exam of visual system	60	56	$94.30	$94.76
99213 Established patient office or other outpatient visit, typically 15 minutes	57	53	$80.15	$80.80
92133 Imaging of optic nerve	51	50	$39.69	$37.95
68761 Closure of tear duct opening using plug	45	27	$304.40	$233.79
92083 Exam of visual field with extended testing	39	38	$67.36	$67.98
66821 Removal of recurring cataract in lens capsule using a laser	34	27	$357.02	$360.42
66821 Removal of recurring cataract in lens capsule using a laser	29	23	$357.02	$338.35
92134 Imaging of retina	20	19	$43.42	$43.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	698	682	$134.45	$133.79
92136 Measurement of corneal curvature and depth of eye	307	163	$75.17	$54.90
66984 Removal of cataract with insertion of lens	303	175	$703.20	$650.01
92004 New patient complete exam of visual system	125	125	$160.55	$159.76
92012 Established patient problem focused exam of visual system	82	78	$93.77	$93.56
99213 Established patient office or other outpatient visit, typically 15 minutes	70	57	$79.45	$78.12
66821 Removal of recurring cataract in lens capsule using a laser	51	41	$356.67	$355.83
66821 Removal of recurring cataract in lens capsule using a laser	47	36	$356.67	$334.27
92083 Exam of visual field with extended testing	45	42	$68.26	$67.95
92133 Imaging of optic nerve	43	42	$39.58	$37.03
68761 Closure of tear duct opening using plug	34	19	$272.21	$204.85
92134 Imaging of retina	20	20	$43.68	$42.43
66982 Complex removal of cataract with insertion of prosthetic lens	17	14	$853.14	$831.06

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	678	667	$134.01	$131.71
92136 Measurement of corneal curvature and depth of eye	312	166	$86.14	$59.35
66984 Removal of cataract with insertion of lens	287	170	$705.82	$637.48
92004 New patient complete exam of visual system	109	109	$160.54	$157.90
92012 Established patient problem focused exam of visual system	73	69	$92.99	$91.69
66821 Removal of recurring cataract in lens capsule using a laser	47	38	$355.46	$349.90
99213 Established patient office or other outpatient visit, typically 15 minutes	43	42	$77.84	$76.77
92083 Exam of visual field with extended testing	40	39	$68.56	$67.56
92133 Imaging of optic nerve	37	37	$40.23	$37.18
66821 Removal of recurring cataract in lens capsule using a laser	34	28	$355.36	$330.06
68761 Closure of tear duct opening using plug	21	15	$281.50	$211.67
66982 Complex removal of cataract with insertion of prosthetic lens	17	12	$855.12	$812.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	701	682	$131.12	$129.26
92136 Measurement of corneal curvature and depth of eye	336	191	$96.12	$66.69
66984 Removal of cataract with insertion of lens	313	191	$693.24	$642.60
92004 New patient complete exam of visual system	95	95	$157.41	$155.17
99213 Established patient office or other outpatient visit, typically 15 minutes	77	70	$77.80	$76.81
92083 Exam of visual field with extended testing	49	46	$68.48	$66.46
92133 Imaging of optic nerve	43	43	$40.66	$36.43
66821 Removal of recurring cataract in lens capsule using a laser	38	29	$352.76	$344.89
92012 Established patient problem focused exam of visual system	23	23	$91.76	$89.46
66821 Removal of recurring cataract in lens capsule using a laser	23	20	$417.13	$321.19
66982 Complex removal of cataract with insertion of prosthetic lens	16	11	$851.41	$837.79

Medical Specialties & State Licenses

CMS Verified: 2024-08-27

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License IL 036-100130

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036100130 (IL)

Commercial Insurance / Payer ID Rr Medicare

180037911 (IL)

Hospital & Practice Group Affiliations

Wheaton Eye Clinic Ltd

2015 N Main St, Wheaton, IL 601873152

Phone: 6306688250

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Susan Anderson-Nelson , MD

Ophthalmology - Retina Specialist

NPI 1013904986

Doctor of Medicine (M.D.)

Dr. Ann Clark , OD

Optometrist

NPI 1073833034

Doctor of Optometry

Dr. Frini Makadia , MD

Ophthalmology - Glaucoma Specialist

NPI 1083069702

Doctor of Medicine (M.D.)

Dr. Gregory Fenton , MD

Ophthalmology

NPI 1114136959

Doctor of Medicine (M.D.)

Dr. Cathleen Cronin , MD

Ophthalmology - Pediatric Ophthalmology and Strabismus Specialist

NPI 1114986296

Doctor of Medicine (M.D.)

Dr. Jeremy Wingard , MD

Ophthalmology - Glaucoma Specialist

NPI 1124218789

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location August 27, 2024

Registered at 2015 N MAIN ST, WHEATON, IL 601873190 (Tel: 6306688250)

📍

Updated Business Mailing Address August 27, 2024

Registered at 2015 N MAIN ST, WHEATON, IL 601873190 (Tel: 6306688250)

👤

Provider Name / Credentials Updated August 27, 2024

Recorded as MICHELLE SIMS, MD

✅

NPI Profile Active March 19, 2009

NPI status registered as active in NPPES database

📍

Updated Practice Location March 19, 2009

Registered at 2015 N MAIN ST, WHEATON, IL 601873152 (Tel: 6306688250)

📍

Updated Business Mailing Address March 19, 2009

Registered at 2015 N MAIN ST, WHEATON, IL 601873152 (Tel: 6306688250)

👤

Provider Name / Credentials Updated March 19, 2009

Recorded as MICHELLE SIMS, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 19, 2009

Ophthalmology (License #036-100130 in IL)

🟢

Initial NPI Registration & Enumeration October 14, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1720077530

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 14, 2005

Last Update: August 27, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2015 N Main St

Wheaton, IL 601873190

Phone: 6306688250

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.