Active NPI 1629242037 Individual Practitioner Male Practitioner

Dr. Michael Thomas Simmons , MD

Surgery • Galax, VA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Michael Simmons, MD is a certified Surgery practicing in Galax, VA. With approximately 11 years of clinical experience since graduating from Medical College Of Georgia School Of Medicine in 2015, Dr. Simmons delivers high-quality medical care to the local community at 225 HOSPITAL DR.

Dr. Simmons is affiliated with Dlp Twin County Physician Practices Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope, dilation of esophagus. 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

Galax, VA 243332228

Telephone 7623669062

Fax 2762367179

Associated Practice Facility / Clinic

🏢 Blue Ridge Surgical Associates Pc Facility NPI 1184728248

Medicare Profile & Education

Medical School

Medical College Of Georgia School Of Medicine

Graduation Year

2015

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Galax, VA

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

11 Yrs -9.5 yrs vs City Avg

City Avg: 20.5 Yrs

State Avg: 24.6 Yrs

Regional Practice Density

4 Specialists

Practicing in Galax, VA (909 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Simmons (11 Years) 11 Yrs

Galax Specialty Average (20.5 Years) 20.5 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
99213 Established patient office or other outpatient visit, typically 15 minutes	143	100	$153.97	$87.90
99213 Established patient office or other outpatient visit, typically 15 minutes	57	49	$126.34	$63.19
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	56	47	$224.41	$123.59
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	53	50	$765.19	$92.58
43450 Dilation of esophagus	39	36	$198.53	$37.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	38	38	$230.00	$105.78
45380 Biopsy of large bowel using an endoscope	27	25	$1041.09	$105.21
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$279.09	$160.96
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	20	18	$94.48	$54.66
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	18	18	$281.56	$124.66
45378 Diagnostic exam of large bowel using a flexible endoscope	17	17	$874.30	$168.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	15	$190.27	$93.22
47562 Removal of gallbladder using an endoscope	16	16	$1408.80	$611.42
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	16	14	$1170.70	$239.32
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	15	12	$306.68	$173.39
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$156.72	$78.39
49505 Repair of groin hernia (5 years or older)	12	12	$1117.03	$501.14
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$159.00	$69.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	86	69	$151.00	$88.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	53	53	$230.00	$110.16
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	49	40	$221.00	$125.74
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	32	27	$765.19	$98.33
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	29	29	$277.00	$160.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	19	$92.81	$55.65
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	24	21	$300.13	$176.05
43450 Dilation of esophagus	19	18	$198.53	$38.89
99202 New patient office or other outpatient visit, typically 20 minutes	13	13	$159.00	$71.19
45378 Diagnostic exam of large bowel using a flexible endoscope	13	13	$874.30	$178.56
45380 Biopsy of large bowel using an endoscope	12	12	$1041.09	$120.10

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	81	63	$151.00	$90.55
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	59	48	$221.00	$127.76
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	53	53	$230.00	$110.94
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	40	29	$92.81	$56.56
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	34	24	$300.13	$176.08
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$277.00	$166.50
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	17	17	$346.00	$220.47
45378 Diagnostic exam of large bowel using a flexible endoscope	11	11	$874.30	$162.10
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	11	11	$765.19	$87.15

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	78	48	$151.00	$91.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	67	50	$221.00	$127.55
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	38	38	$277.00	$168.75
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	36	21	$145.91	$71.42
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	16	16	$413.30	$199.00
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$281.56	$135.14
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$230.00	$112.95
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$98.10	$56.54

Medical Specialties & State Licenses

CMS Verified: 2022-04-25

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License VA 0101271193

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

State License AL L.4246R

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Hospital & Practice Group Affiliations

Dlp Twin County Physician Practices Llc

225 Hospital Dr, Galax, VA 243332228

Phone: 2762366906

Practice Associates & Co-Workers

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

3 Associated Practitioners

Dr. Anne Barnwell-Grayson , MD

Surgery

NPI 1013046994

Doctor of Medicine (M.D.)

Dr. Mahmoud Jawhar , MD

Surgery

NPI 1124094875

Doctor of Medicine (M.D.)

Dr. Mark Mattson , MD

Surgery

NPI 1902900079

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 April 25, 2022

Registered at 225 HOSPITAL DR, GALAX, VA 243332228 (Tel: 7623669062)

📍

Updated Business Mailing Address April 25, 2022

Registered at 225 HOSPITAL DR, GALAX, VA 243332228 (Tel: 2762366906)

👤

Provider Name / Credentials Updated April 25, 2022

Recorded as MICHAEL SIMMONS, MD

✅

NPI Profile Active March 10, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location March 10, 2016

Registered at 14089 ABERCORN ST, SAVANNAH, GA 314191966 (Tel: 9123502129)

📍

Updated Business Mailing Address March 10, 2016

Registered at 2451 FILLINGIM ST, RM 714, MOBILE, AL 366172238 (Tel: 2514717117)

👤

Provider Name / Credentials Updated March 10, 2016

Recorded as MICHAEL SIMMONS, PA-C, MSPAS

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 10, 2016

Student in an Organized Health Care Education/Training Program (License #L.4246R in AL)

🟢

Initial NPI Registration & Enumeration April 16, 2008

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: 1629242037

Entity Type:

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

Enumeration Date: April 16, 2008

Last Update: April 25, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

225 Hospital Dr

Galax, VA 243332228

Phone: 2762366906

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.