Active NPI 1205891512 Individual Practitioner Male Practitioner

Dr. Daniel J Simon , MD

Ophthalmology • Durham, NC

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Daniel Simon, MD is a certified Ophthalmology practicing in Durham, NC. With approximately 24 years of clinical experience since graduating from State University Of New York Downstate Medical Center in 2002, Dr. Simon delivers high-quality medical care to the local community at 4102 N ROXBORO ST.

Dr. Simon is affiliated with Duke Health Integrated Practice Inc 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, established 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

4102 N Roxboro St

Durham, NC 277042122

Telephone 9195952000

Fax 9195952190

Associated Practice Facility / Clinic

🏢 North Carolina Eye Ear Nose & Throat Pa Facility NPI 1972504926

Medicare Profile & Education

Medical School

State University Of New York Downstate Medical Center

Graduation Year

2002

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Durham, NC

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

24 Yrs +2.9 yrs vs City Avg

City Avg: 21.1 Yrs

State Avg: 27.2 Yrs

Regional Practice Density

94 Specialists

Practicing in Durham, NC (718 Statewide)

Telehealth Adoption Rate

4.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

77.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Simon (24 Years) 24 Yrs

Durham Specialty Average (21.1 Years) 21.1 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	484	477	$291.00	$117.35
92136 Measurement of corneal curvature and depth of eye	238	99	$143.32	$33.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	237	219	$255.00	$119.50
66984 Removal of cataract with insertion of lens	187	91	$2939.20	$384.89
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	184	184	$390.00	$155.91
92012 Established patient problem focused exam of visual system	178	155	$201.00	$82.59
92133 Imaging of optic nerve	121	121	$171.00	$33.40
92083 Exam of visual field with extended testing	88	83	$329.00	$57.92
99213 Established patient office or other outpatient visit, typically 15 minutes	80	78	$172.00	$84.38
66821 Removal of recurring cataract in lens capsule using a laser	63	47	$1550.00	$305.20
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	34	30	$61.00	$15.48
92134 Imaging of retina	31	29	$172.00	$37.21
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$255.00	$103.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	603	578	$291.00	$119.37
92012 Established patient problem focused exam of visual system	330	261	$201.00	$84.76
92136 Measurement of corneal curvature and depth of eye	203	88	$144.03	$26.20
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	190	190	$390.00	$157.33
66984 Removal of cataract with insertion of lens	165	93	$3112.88	$424.06
92133 Imaging of optic nerve	155	153	$171.00	$34.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	125	114	$255.00	$120.34
92083 Exam of visual field with extended testing	89	86	$329.00	$58.71
66821 Removal of recurring cataract in lens capsule using a laser	41	34	$1550.00	$313.03
92134 Imaging of retina	24	24	$172.00	$38.02
99213 Established patient office or other outpatient visit, typically 15 minutes	21	21	$172.00	$83.32
92228 Imaging of retina with remote review by physician	12	12	$100.00	$27.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	607	588	$291.00	$120.94
92012 Established patient problem focused exam of visual system	354	267	$201.00	$85.50
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	189	189	$390.00	$161.02
66984 Removal of cataract with insertion of lens	180	110	$3486.22	$484.70
92133 Imaging of optic nerve	129	129	$171.00	$35.06
92083 Exam of visual field with extended testing	111	104	$329.00	$58.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	84	84	$258.21	$122.00
66821 Removal of recurring cataract in lens capsule using a laser	82	64	$1550.00	$317.78
66984 Removal of cataract with insertion of lens	65	23	$395.66	$13.58
99213 Established patient office or other outpatient visit, typically 15 minutes	33	32	$172.00	$83.80
92134 Imaging of retina	28	25	$172.00	$38.48
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	23	23	$255.00	$107.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	572	542	$291.00	$122.12
92012 Established patient problem focused exam of visual system	338	239	$201.00	$86.26
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	186	186	$390.00	$160.35
92133 Imaging of optic nerve	169	169	$171.00	$35.87
66984 Removal of cataract with insertion of lens	147	92	$3639.01	$515.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	99	98	$256.36	$121.60
92083 Exam of visual field with extended testing	94	91	$329.00	$59.68
66821 Removal of recurring cataract in lens capsule using a laser	60	46	$1550.00	$311.95
92134 Imaging of retina	39	37	$172.00	$39.51
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	25	25	$255.00	$109.01
99213 Established patient office or other outpatient visit, typically 15 minutes	25	25	$172.00	$85.14
65855 Laser repair to improve eye fluid flow	23	12	$2078.00	$228.52
92228 Imaging of retina with remote review by physician	11	11	$91.45	$29.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	553	530	$291.00	$123.37
92012 Established patient problem focused exam of visual system	305	220	$201.30	$86.25
92133 Imaging of optic nerve	147	147	$171.00	$36.19
66984 Removal of cataract with insertion of lens	140	81	$3548.03	$504.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	115	115	$390.00	$157.65
92083 Exam of visual field with extended testing	91	81	$329.00	$61.50
99213 Established patient office or other outpatient visit, typically 15 minutes	58	57	$172.00	$73.46
66821 Removal of recurring cataract in lens capsule using a laser	38	35	$1550.00	$325.19
92136 Measurement of corneal curvature and depth of eye	37	23	$113.68	$34.28
92134 Imaging of retina	21	21	$172.00	$40.05
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$255.00	$99.74
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	14	14	$255.00	$97.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	695	661	$256.11	$122.64
92012 Established patient problem focused exam of visual system	417	309	$176.56	$85.20
66984 Removal of cataract with insertion of lens	293	143	$2384.20	$442.84
92136 Measurement of corneal curvature and depth of eye	164	74	$125.69	$32.77
92133 Imaging of optic nerve	156	155	$150.60	$35.96
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	130	130	$323.37	$156.64
92083 Exam of visual field with extended testing	119	109	$264.59	$61.71
66821 Removal of recurring cataract in lens capsule using a laser	69	58	$1408.70	$321.97
66984 Removal of cataract with insertion of lens	55	14	$253.84	$1.23
99213 Established patient office or other outpatient visit, typically 15 minutes	52	50	$158.52	$70.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	31	31	$179.52	$105.45
92134 Imaging of retina	30	29	$148.80	$39.82
65855 Laser repair to improve eye fluid flow	23	14	$1968.04	$240.41
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$234.17	$104.56
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	15	$103.47	$43.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	759	718	$150.00	$121.05
92012 Established patient problem focused exam of visual system	480	329	$110.00	$83.71
92136 Measurement of corneal curvature and depth of eye	349	136	$133.45	$35.56
66984 Removal of cataract with insertion of lens	241	129	$2037.56	$496.39
92133 Imaging of optic nerve	177	177	$85.00	$36.12
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	150	150	$200.00	$157.18
92083 Exam of visual field with extended testing	145	134	$110.00	$61.12
66821 Removal of recurring cataract in lens capsule using a laser	78	60	$900.00	$316.42
99213 Established patient office or other outpatient visit, typically 15 minutes	76	67	$90.00	$64.37
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	76	75	$130.00	$102.40
65855 Laser repair to improve eye fluid flow	34	22	$1235.00	$229.73
92134 Imaging of retina	27	27	$85.00	$39.80
67820 Removal of eyelashes using forceps	20	14	$110.00	$38.63
92250 Photography of the retina	17	17	$85.00	$54.45

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	869	815	$150.00	$118.17
92012 Established patient problem focused exam of visual system	576	397	$110.00	$81.41
92136 Measurement of corneal curvature and depth of eye	413	166	$130.93	$39.94
66984 Removal of cataract with insertion of lens	297	170	$2127.93	$517.58
92133 Imaging of optic nerve	182	179	$85.00	$35.49
92083 Exam of visual field with extended testing	144	134	$110.00	$61.04
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	136	136	$200.22	$156.15
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	119	117	$130.50	$101.05
66821 Removal of recurring cataract in lens capsule using a laser	56	48	$900.00	$313.53
92134 Imaging of retina	40	39	$85.00	$39.07
92250 Photography of the retina	24	24	$85.00	$62.26
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	18	$62.78	$41.44
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$130.00	$102.90
67820 Removal of eyelashes using forceps	16	11	$110.00	$48.21
99213 Established patient office or other outpatient visit, typically 15 minutes	16	16	$90.00	$69.67
65855 Laser repair to improve eye fluid flow	16	11	$1235.00	$233.57

Medical Specialties & State Licenses

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License NC 2006-00474

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.

Ophthalmology

NUCC Taxonomy Code: 207W00000X

State License SC TL28671

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Nc Medical License

2006-00474 (NC)

Commercial Insurance / Payer ID Sc Medical License

TL28671 (SC)

Hospital & Practice Group Affiliations

Duke Health Integrated Practice Inc

4102 N Roxboro St, Durham, NC 277042122

Phone: 9196848111

Duke Health Integrated Practice Inc

1838 Martin Luther King Jr Blvd, Chapel Hill, NC 275147415

Phone: 9196848111

Duke Health Integrated Practice Inc

5726 Fayetteville Rd, Durham, NC 277136296

Phone: 9196848111

Duke Health Integrated Practice Inc

40 Duke Medicine Cir, Durham, NC 277104000

Phone: 9196848111

Practice Associates & Co-Workers

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

29 Associated Practitioners

Dr. Jeremiah Marion , MD

Ophthalmology

NPI 1053312884

Doctor of Medicine (M.D.)

Dr. Andrea Engel , AuD

Audiologist

NPI 1114114915

Doctor of Audiology

Julie Rockefeller , MS CCC-SLP

Speech-Language Pathologist

NPI 1184811663

MSCCCSLP

Havan Harris , MS, CCC-SLP

Speech-Language Pathologist

NPI 1194450999

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

Dr. Edward Hedgpeth , MD

Ophthalmology

NPI 1205837572

Doctor of Medicine (M.D.)

Dr. Sarah Hodges , MD

Otolaryngology

NPI 1255371720

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active September 22, 2009

NPI status registered as active in NPPES database

📍

Updated Practice Location September 22, 2009

Registered at 4102 N ROXBORO ST, DURHAM, NC 277042122 (Tel: 9195952000)

📍

Updated Business Mailing Address September 22, 2009

Registered at 4102 N ROXBORO ST, DURHAM, NC 277042122 (Tel: 9195952000)

👤

Provider Name / Credentials Updated September 22, 2009

Recorded as DANIEL SIMON, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 22, 2009

Ophthalmology (License #2006-00474 in NC)

🟢

Initial NPI Registration & Enumeration April 19, 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: 1205891512

Entity Type:

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

Enumeration Date: April 19, 2006

Last Update: September 22, 2009

Sole Proprietor: No

Update or Correct Profile

Mailing Address

4102 N Roxboro St

Durham, NC 277042122

Phone: 9195952000

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.