Active NPI 1538110572 Individual Practitioner Male Practitioner

Dr. Mark Simon , MD

Ophthalmology • Winchester, KY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Mark Simon, MD is a certified Ophthalmology practicing in Winchester, KY. With approximately 37 years of clinical experience since graduating from University Of Kentucky College Of Medicine in 1989, Dr. Simon delivers high-quality medical care to the local community at 225 HOSPITAL DR STE 160.

Dr. Simon accepts Medicare assignment.

Frequently performed procedures and clinical services include measurement of corneal curvature and depth of eye, removal of cataract with insertion of lens, new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

225 Hospital Dr Ste 160

Winchester, KY 403917635

Telephone 8597443937

Fax 8597443941

Associated Practice Facility / Clinic

🏢 Premier Eye Care, Pllc Facility NPI 1942394028

Medicare Profile & Education

Medical School

University Of Kentucky College Of Medicine

Graduation Year

1989

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Winchester, KY

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

37 Yrs Matches City Avg

City Avg: 37.0 Yrs

State Avg: 28.2 Yrs

Regional Practice Density

2 Specialists

Practicing in Winchester, KY (265 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

53.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Simon (37 Years) 37 Yrs

Winchester Specialty Average (37.0 Years) 37.0 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
92136 Measurement of corneal curvature and depth of eye	68	45	$110.01	$35.94
66984 Removal of cataract with insertion of lens	47	31	$1100.00	$396.24
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	43	43	$225.00	$152.50
66821 Removal of recurring cataract in lens capsule using a laser	24	18	$390.00	$300.09
66982 Complex removal of cataract with insertion of prosthetic lens	16	12	$1500.00	$575.11
92014 Established patient complete exam of visual system	15	15	$156.00	$114.32
92012 Established patient problem focused exam of visual system	11	11	$110.00	$80.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92136 Measurement of corneal curvature and depth of eye	93	61	$105.52	$35.68
66984 Removal of cataract with insertion of lens	85	51	$1100.00	$415.60
92004 New patient complete exam of visual system	54	54	$211.00	$133.58
66821 Removal of recurring cataract in lens capsule using a laser	26	17	$390.00	$302.56
92012 Established patient problem focused exam of visual system	22	21	$110.00	$81.73
92014 Established patient complete exam of visual system	17	17	$156.00	$115.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92136 Measurement of corneal curvature and depth of eye	126	82	$105.40	$38.39
66984 Removal of cataract with insertion of lens	106	61	$1100.00	$416.05
92004 New patient complete exam of visual system	72	72	$211.00	$139.01
66821 Removal of recurring cataract in lens capsule using a laser	32	19	$390.00	$304.70
92014 Established patient complete exam of visual system	29	27	$156.00	$116.78
92012 Established patient problem focused exam of visual system	21	21	$110.00	$82.01
66982 Complex removal of cataract with insertion of prosthetic lens	17	11	$1500.00	$567.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92136 Measurement of corneal curvature and depth of eye	171	113	$106.39	$42.02
66984 Removal of cataract with insertion of lens	151	90	$1100.00	$435.57
92004 New patient complete exam of visual system	118	118	$211.00	$141.58
66984 Removal of cataract with insertion of lens	96	19	$6.00	$1.15
66821 Removal of recurring cataract in lens capsule using a laser	63	39	$390.00	$305.91
92012 Established patient problem focused exam of visual system	42	39	$110.00	$83.15
92014 Established patient complete exam of visual system	34	33	$156.00	$119.42
66982 Complex removal of cataract with insertion of prosthetic lens	17	12	$1500.00	$591.64

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	254	247	$156.00	$117.04
92012 Established patient problem focused exam of visual system	150	133	$110.00	$82.46
92136 Measurement of corneal curvature and depth of eye	146	97	$106.25	$45.13
66984 Removal of cataract with insertion of lens	138	82	$1100.00	$465.53
92250 Photography of the retina	135	135	$120.00	$40.94
92004 New patient complete exam of visual system	126	126	$211.00	$140.16
66984 Removal of cataract with insertion of lens	124	21	$6.00	$1.15
66821 Removal of recurring cataract in lens capsule using a laser	89	59	$390.00	$305.81
92134 Imaging of retina	31	30	$70.00	$37.74
92083 Exam of visual field with extended testing	26	26	$110.00	$58.16
92133 Imaging of optic nerve	21	21	$70.00	$34.54
66982 Complex removal of cataract with insertion of prosthetic lens	15	12	$1500.00	$598.33
92002 New patient problem focused exam of visual system	14	14	$85.00	$78.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	460	442	$156.00	$116.50
92012 Established patient problem focused exam of visual system	319	233	$110.00	$81.09
92250 Photography of the retina	280	278	$120.00	$45.04
92136 Measurement of corneal curvature and depth of eye	178	116	$104.37	$48.41
66984 Removal of cataract with insertion of lens	168	25	$6.00	$1.34
66984 Removal of cataract with insertion of lens	159	93	$1100.00	$559.17
92004 New patient complete exam of visual system	150	150	$211.00	$139.38
66821 Removal of recurring cataract in lens capsule using a laser	120	78	$390.00	$303.13
92133 Imaging of optic nerve	87	86	$70.00	$33.53
92134 Imaging of retina	85	80	$70.00	$37.49
92132 Imaging of front third of eye	83	83	$65.00	$26.47
92083 Exam of visual field with extended testing	76	72	$110.00	$57.89
66982 Complex removal of cataract with insertion of prosthetic lens	27	21	$1500.00	$678.00
76514 Ultrasound scan of cornea to determine thickness	19	19	$25.00	$10.64
92020 Examination of cornea and iris using lens device and slit lamp	14	14	$90.00	$25.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	517	501	$156.00	$113.15
92136 Measurement of corneal curvature and depth of eye	351	226	$106.80	$51.91
92250 Photography of the retina	324	324	$120.00	$49.50
66984 Removal of cataract with insertion of lens	315	189	$1100.00	$517.11
92012 Established patient problem focused exam of visual system	282	212	$110.00	$78.52
92004 New patient complete exam of visual system	240	240	$211.00	$135.94
66984 Removal of cataract with insertion of lens	128	22	$6.00	$1.30
66821 Removal of recurring cataract in lens capsule using a laser	123	74	$390.00	$297.88
92132 Imaging of front third of eye	106	106	$65.00	$25.59
92133 Imaging of optic nerve	57	55	$70.00	$33.46
92083 Exam of visual field with extended testing	55	52	$110.00	$55.95
92134 Imaging of retina	50	48	$70.00	$36.89
66982 Complex removal of cataract with insertion of prosthetic lens	34	29	$1500.00	$613.40
76519 Ultrasound of eye for determination of lens power	17	16	$131.76	$59.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	479	459	$156.00	$113.34
92136 Measurement of corneal curvature and depth of eye	452	284	$105.24	$57.87
66984 Removal of cataract with insertion of lens	413	240	$1100.00	$506.68
92004 New patient complete exam of visual system	301	301	$211.00	$137.21
92012 Established patient problem focused exam of visual system	232	190	$110.00	$77.69
66984 Removal of cataract with insertion of lens	196	29	$6.00	$1.32
92134 Imaging of retina	180	174	$70.00	$37.07
92133 Imaging of optic nerve	146	145	$70.00	$33.53
66821 Removal of recurring cataract in lens capsule using a laser	83	56	$390.00	$294.82
66982 Complex removal of cataract with insertion of prosthetic lens	52	40	$1500.00	$652.38
92083 Exam of visual field with extended testing	46	45	$110.00	$56.93
76519 Ultrasound of eye for determination of lens power	31	27	$122.35	$65.86
92250 Photography of the retina	20	20	$120.00	$56.74

Medical Specialties & State Licenses

CMS Verified: 2022-07-11

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License KY 29402

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

64294028 (KY)

Practice Associates & Co-Workers

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

2 Associated Practitioners

Dr. Aaron Mullins , OD

Optometrist

NPI 1124648761

Doctor of Optometry

Dr. Laurence Riel , OD

Optometrist

NPI 1770465775

Doctor of Optometry

Career & Practice History Timeline

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

9 Historical Events

📍

Updated Practice Location September 30, 2019

Registered at 225 HOSPITAL DR STE 160, WINCHESTER, KY 403917635 (Tel: 8597443937)

📍

Updated Business Mailing Address September 30, 2019

Registered at 225 HOSPITAL DR STE 160, WINCHESTER, KY 403917635 (Tel: 8597443937)

👤

Provider Name / Credentials Updated September 30, 2019

Recorded as MARK SIMON, MD

✅

NPI Profile Active June 07, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location June 07, 2011

Registered at 1109 MCCANN DR, SUITE 2, WINCHESTER, KY 403911178 (Tel: 8597443937)

📍

Updated Business Mailing Address June 07, 2011

Registered at 1109 MCCANN DR, SUITE 2, WINCHESTER, KY 403911178 (Tel: 8597443937)

👤

Provider Name / Credentials Updated June 07, 2011

Recorded as MARK SIMON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 07, 2011

Ophthalmology (License #29402 in KY)

🟢

Initial NPI Registration & Enumeration May 15, 2006

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: 1538110572

Entity Type:

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

Enumeration Date: May 15, 2006

Last Update: July 11, 2022

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

225 Hospital Dr Ste 160

Winchester, KY 403917635

Phone: 8597443937

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.