Active NPI 1619013778 Individual Practitioner Male Practitioner

Dr. Marc Lee Simon , DO

Surgery • Denville, NJ

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Marc Simon, DO is a certified Surgery practicing in Denville, NJ. With approximately 48 years of clinical experience since graduating from Philadelphia College Of Osteopathic Medicine in 1978, Dr. Simon delivers high-quality medical care to the local community at 16 POCONO RD STE 310.

Dr. Simon accepts Medicare assignment.

Frequently performed procedures and clinical services include new patient outpatient office visit, established patient outpatient office visit, repair of groin hernia (5 years or older). Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

16 Pocono Rd Ste 310

Denville, NJ 078342908

Telephone 9736274227

Fax 9736647572

Medicare Profile & Education

Medical School

Philadelphia College Of Osteopathic Medicine

Graduation Year

1978

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Denville, NJ

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

48 Yrs +18.5 yrs vs City Avg

City Avg: 29.5 Yrs

State Avg: 26.9 Yrs

Regional Practice Density

3 Specialists

Practicing in Denville, NJ (815 Statewide)

Telehealth Adoption Rate

33.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

71.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Simon (48 Years) 48 Yrs

Denville Specialty Average (29.5 Years) 29.5 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
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	62	62	$375.00	$120.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	23	19	$297.83	$140.20
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	16	11	$125.00	$62.32
49505 Repair of groin hernia (5 years or older)	11	11	$2290.91	$569.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	53	53	$321.89	$123.87
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	29	21	$125.00	$63.03
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	20	17	$394.00	$140.90
49505 Repair of groin hernia (5 years or older)	12	12	$1238.33	$550.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	63	63	$547.19	$125.65
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	25	23	$919.76	$213.03
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	23	11	$297.83	$76.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	20	18	$534.80	$143.05
49505 Repair of groin hernia (5 years or older)	16	16	$2557.63	$586.38

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	41	41	$186.41	$126.76
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	19	$209.68	$146.08
99213 Established patient office or other outpatient visit, typically 15 minutes	14	12	$132.57	$103.23
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	11	11	$334.82	$217.60
49505 Repair of groin hernia (5 years or older)	11	11	$993.45	$589.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	25	24	$310.00	$225.29
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$169.00	$122.49
99213 Established patient office or other outpatient visit, typically 15 minutes	15	12	$114.00	$85.81
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$117.00	$86.92
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	11	11	$1435.45	$782.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	43	43	$363.00	$120.87
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	19	$363.00	$121.26
99213 Established patient office or other outpatient visit, typically 15 minutes	19	19	$246.00	$83.05
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	17	17	$450.00	$148.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	56	56	$483.79	$177.09
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	25	$339.54	$118.87
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$346.94	$119.48
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	16	15	$651.19	$218.44
99213 Established patient office or other outpatient visit, typically 15 minutes	15	11	$233.07	$80.73
49505 Repair of groin hernia (5 years or older)	12	12	$1632.25	$573.29

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	66	66	$383.00	$180.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	39	33	$233.00	$118.56
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	29	13	$152.00	$77.68
49505 Repair of groin hernia (5 years or older)	17	17	$1282.00	$576.88
99213 Established patient office or other outpatient visit, typically 15 minutes	16	16	$149.00	$80.79
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	11	11	$308.00	$147.27
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$272.00	$120.11

Medical Specialties & State Licenses

CMS Verified: 2022-04-27

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License NJ 25MB03674200

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

1607901 (NJ)

Practice Associates & Co-Workers

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

1 Associated Practitioners

Dr. Peter Heit , MD

Internal Medicine - Gastroenterology

NPI 1912952763

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

10 Historical Events

👤

Provider Name / Credentials Updated April 27, 2022

Recorded as MARC SIMON, DO

📍

Updated Business Mailing Address March 18, 2022

Registered at 16 POCONO RD STE 310, DENVILLE, NJ 078342908 (Tel: 9736274227)

📍

Updated Practice Location January 02, 2020

Registered at 16 POCONO RD STE 310, DENVILLE, NJ 078342908 (Tel: 9736274227)

📍

Updated Business Mailing Address January 02, 2020

Registered at 700 ROUTE 46 E STE 450, FAIRFIELD, NJ 070041583 (Tel: 9735593700)

✅

NPI Profile Active February 06, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location February 06, 2016

Registered at 16 POCONO RD, SUITE 310, DENVILLE, NJ 078342901 (Tel: 9736274227)

📍

Updated Business Mailing Address February 06, 2016

Registered at PO BOX 416457, BOSTON, MA 022416457

👤

Provider Name / Credentials Updated February 06, 2016

Recorded as MARC SIMON, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 06, 2016

Surgery (License #25MB03674200 in NJ)

🟢

Initial NPI Registration & Enumeration January 29, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

No patient reviews submitted yet for Dr. Marc Simon. Be the first to share your experience!

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1619013778

Entity Type:

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

Enumeration Date: January 29, 2007

Last Update: April 27, 2022

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

16 Pocono Rd Ste 310

Denville, NJ 078342908

Phone: 9736274227

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.