Active NPI 1902849045 Individual Practitioner Female Practitioner

Dr. Sidney Kay Simonian , DO

Ophthalmology • Madison Heights, MI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Sidney Simonian, DO is a certified Ophthalmology practicing in Madison Heights, MI. With approximately 52 years of clinical experience since graduating from Albany Medical College Of Union University in 1974, Dr. Simonian delivers high-quality medical care to the local community at 1421 E. 12 MILE.

Dr. Simonian is affiliated with Michigan Healthcare Professionals Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient complete exam of visual system, established patient problem focused exam of visual system, photography of the retina. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1421 E. 12 Mile
Bldg. A

Madison Heights, MI 480712653

Telephone 2485476656

Fax 2485475407

Associated Practice Facility / Clinic

🏢 Drs Rubin And Simonian Pc Facility NPI 1548444565

Medicare Profile & Education

Medical School

Albany Medical College Of Union University

Graduation Year

1974

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Madison Heights, MI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

52 Yrs +29.2 yrs vs City Avg

City Avg: 22.8 Yrs

State Avg: 27.6 Yrs

Regional Practice Density

5 Specialists

Practicing in Madison Heights, MI (843 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

50.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Simonian (52 Years) 52 Yrs

Madison Heights Specialty Average (22.8 Years) 22.8 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	340	314	$170.00	$123.36
92012 Established patient problem focused exam of visual system	281	148	$120.00	$87.74
92250 Photography of the retina	216	212	$150.00	$36.49
92083 Exam of visual field with extended testing	84	83	$150.00	$62.37
92133 Imaging of optic nerve	80	79	$80.00	$33.24
76514 Ultrasound scan of cornea to determine thickness	77	76	$70.00	$10.84
92004 New patient complete exam of visual system	62	62	$195.00	$146.65
76519 Ultrasound of eye for determination of lens power	48	29	$145.00	$50.16
92134 Imaging of retina	45	40	$85.00	$39.73
66984 Removal of cataract with insertion of lens	44	25	$1320.00	$534.89
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	28	26	$145.00	$128.26
66821 Removal of recurring cataract in lens capsule using a laser	18	16	$600.00	$331.73

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	330	309	$170.00	$125.07
92012 Established patient problem focused exam of visual system	265	148	$120.00	$89.09
92250 Photography of the retina	212	208	$150.00	$37.25
92083 Exam of visual field with extended testing	79	77	$150.00	$62.18
76514 Ultrasound scan of cornea to determine thickness	72	70	$70.00	$10.99
92133 Imaging of optic nerve	71	70	$80.00	$33.76
92004 New patient complete exam of visual system	47	47	$195.00	$145.88
92134 Imaging of retina	46	44	$85.00	$40.16
66984 Removal of cataract with insertion of lens	31	20	$1320.00	$543.71
76519 Ultrasound of eye for determination of lens power	30	20	$145.00	$52.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	326	307	$170.00	$127.75
92012 Established patient problem focused exam of visual system	320	164	$120.00	$90.77
92250 Photography of the retina	200	191	$150.00	$37.63
92083 Exam of visual field with extended testing	92	89	$150.00	$64.15
76514 Ultrasound scan of cornea to determine thickness	84	83	$70.00	$11.45
92133 Imaging of optic nerve	80	79	$80.00	$35.18
92004 New patient complete exam of visual system	65	65	$195.00	$151.23
76519 Ultrasound of eye for determination of lens power	51	33	$145.00	$53.30
92134 Imaging of retina	49	44	$85.00	$41.13
66984 Removal of cataract with insertion of lens	40	25	$1320.00	$557.84
66821 Removal of recurring cataract in lens capsule using a laser	15	14	$600.00	$343.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	323	307	$170.00	$129.70
92012 Established patient problem focused exam of visual system	313	179	$120.00	$92.29
92250 Photography of the retina	175	168	$150.00	$40.37
92083 Exam of visual field with extended testing	96	95	$150.00	$64.99
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	92	87	$145.00	$134.45
92133 Imaging of optic nerve	86	85	$80.00	$36.11
76514 Ultrasound scan of cornea to determine thickness	75	74	$70.00	$11.65
92134 Imaging of retina	63	56	$85.00	$41.77
76519 Ultrasound of eye for determination of lens power	60	40	$145.00	$55.31
66984 Removal of cataract with insertion of lens	50	33	$1320.00	$563.96
99213 Established patient office or other outpatient visit, typically 15 minutes	37	35	$95.00	$93.79
92004 New patient complete exam of visual system	28	28	$195.00	$154.48
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	24	24	$215.00	$164.16
66821 Removal of recurring cataract in lens capsule using a laser	19	15	$600.00	$329.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	357	346	$170.00	$128.89
92012 Established patient problem focused exam of visual system	270	154	$120.00	$89.81
92250 Photography of the retina	109	108	$150.00	$45.43
92133 Imaging of optic nerve	82	81	$80.00	$36.41
92083 Exam of visual field with extended testing	81	81	$150.00	$64.34
76514 Ultrasound scan of cornea to determine thickness	62	60	$70.00	$11.91
92134 Imaging of retina	56	52	$85.00	$41.71
66984 Removal of cataract with insertion of lens	55	35	$1320.00	$572.20
76519 Ultrasound of eye for determination of lens power	54	35	$145.00	$53.03
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	33	33	$215.00	$168.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	14	$145.00	$113.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	410	389	$170.00	$126.70
92012 Established patient problem focused exam of visual system	331	183	$120.00	$87.42
92083 Exam of visual field with extended testing	101	99	$150.00	$64.52
92133 Imaging of optic nerve	100	98	$80.05	$35.94
92250 Photography of the retina	95	94	$150.00	$49.61
76519 Ultrasound of eye for determination of lens power	80	51	$145.00	$50.70
66984 Removal of cataract with insertion of lens	76	46	$1320.00	$652.06
92134 Imaging of retina	69	61	$85.00	$41.08
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	62	62	$215.00	$169.62
76514 Ultrasound scan of cornea to determine thickness	58	56	$70.00	$12.19
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	45	43	$145.00	$111.17
66821 Removal of recurring cataract in lens capsule using a laser	30	26	$600.00	$339.40
92025 Ct scan of cornea	28	27	$65.00	$34.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	428	411	$170.00	$123.06
92012 Established patient problem focused exam of visual system	306	175	$120.00	$85.15
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	190	151	$145.00	$106.46
76519 Ultrasound of eye for determination of lens power	114	72	$145.00	$52.10
92083 Exam of visual field with extended testing	109	99	$150.00	$62.58
92250 Photography of the retina	100	99	$150.00	$55.48
66984 Removal of cataract with insertion of lens	99	59	$1320.00	$633.44
92133 Imaging of optic nerve	95	95	$80.00	$35.99
92134 Imaging of retina	83	69	$85.00	$39.85
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	69	69	$215.00	$164.14
92025 Ct scan of cornea	53	52	$65.00	$34.57
76514 Ultrasound scan of cornea to determine thickness	33	32	$70.00	$14.78
66821 Removal of recurring cataract in lens capsule using a laser	24	24	$600.00	$326.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	441	410	$170.00	$123.78
92012 Established patient problem focused exam of visual system	282	170	$120.00	$84.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	191	154	$145.00	$108.66
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	121	121	$215.00	$164.59
92083 Exam of visual field with extended testing	112	102	$150.00	$63.63
92133 Imaging of optic nerve	110	110	$80.00	$36.80
66984 Removal of cataract with insertion of lens	104	67	$1320.00	$634.42
76519 Ultrasound of eye for determination of lens power	103	73	$145.00	$64.52
92250 Photography of the retina	87	86	$150.00	$65.71
92134 Imaging of retina	48	43	$85.00	$40.06
76514 Ultrasound scan of cornea to determine thickness	27	27	$70.00	$14.62
66821 Removal of recurring cataract in lens capsule using a laser	22	21	$600.00	$340.08
92004 New patient complete exam of visual system	19	19	$193.68	$149.31
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	11	11	$210.00	$140.15
92285 Photography of content of eyes	11	11	$60.00	$17.24

Medical Specialties & State Licenses

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License MI SS0007420

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

139455411 (MI)

Commercial Insurance / Payer ID Mrrr

180008618 (MI)

Commercial Insurance / Payer ID Bcn

1856303004 (MI)

Commercial Insurance / Payer ID Blue Cross Blue Shield

5630300 (MI)

Commercial Insurance / Payer ID Mrpb

8631110001 (MI)

Commercial Insurance / Payer ID Vision Service Plan / Vsp

382318591 (MI)

Commercial Insurance / Payer ID Commercial

382318591 (MI)

Hospital & Practice Group Affiliations

Michigan Healthcare Professionals Pc

1421 E 12 Mile Rd Bldg A, Madison Heights, MI 480712653

Phone: 2485476656

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active June 03, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location June 03, 2011

Registered at 1421 E. 12 MILE, BLDG. A, MADISON HEIGHTS, MI 480712653 (Tel: 2485476656)

📍

Updated Business Mailing Address June 03, 2011

Registered at 1421 E 12 MILE RD BLDG A, MADISON HEIGHTS, MI 480712653 (Tel: 2485476656)

👤

Provider Name / Credentials Updated June 03, 2011

Recorded as SIDNEY SIMONIAN, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 03, 2011

Ophthalmology (License #SS0007420 in MI)

🟢

Initial NPI Registration & Enumeration June 14, 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: 1902849045

Entity Type:

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

Enumeration Date: June 14, 2006

Last Update: June 03, 2011

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1421 E 12 Mile Rd Bldg A

Madison Heights, MI 480712653

Phone: 2485476656

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.