SAMUEL SIMMONS (PA-C) – Medical Physician Assistant, NPI 1619305828
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
553 PHYSICIAN ASSISTANT in AK
Provider Addresses for SAMUEL SIMMONS (PA-C)
350 14th Ave
Skagway, AK 998400537
Phone: (907) 983-2255
Fax: (907) 983-2793
Type: Location
PO BOX 98978
LAS VEGAS, NV 891938978
Phone: (702) 216-3346
Fax: (702) 671-6883
Type: Mailing
1280 E CALVADA BLVD
PAHRUMP, NV 890485693
Phone: (775) 751-3377
Fax: (775) 751-2323
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-03-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230220000010 | I | Physician Assistant | TX | TBD |
| I20240307003692 | I | Physician Assistant | AK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 16 | 12 | $0 |
Insurance plans in this area (ZIP 99840)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AZ | |
| Physician Assistant | MN | |
| Physician Assistant | AK | |
| Physician Assistant | AK | |
| Mental Health Counselor | SD | |
| - | GA | |
| Nurse Practitioner | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| Physician Assistant | AK | |
| Physician Assistant | AK |
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