SIMON A HOLOUBEK (D.O.) – Surgery Physician, NPI 1043697618
Surgery Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,092 GENERAL SURGERY in GA
Provider Addresses for SIMON A HOLOUBEK (D.O.)
1120 15TH ST STE BI1056
AUGUSTA, GA 309120004
Phone: (706) 721-3813
Type: Mailing
1120 15TH ST
AUGUSTA, GA 309121010
Phone: (706) 721-8623
Fax: (706) 721-1459
Type: Location
600 Highland Ave
Madison, WI 537921010
Phone: (608) 263-7502
Fax: (608) 263-7652
Type: Location
7974 UW HEALTH CT
MIDDLETON, WI 535625531
Phone:
Type: Mailing
1340 CHARLES ST STE 100&405
ROCKFORD, IL 611042200
Phone: (779) 696-8700
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $13,561.
Total Amount is formed as General ($13,561) + Research ($0) + Ownership ($0) = $13,561.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Medtronic, Inc. ($13,327).
Total Amount
$13,561
General + Research + Ownership
Payments
23
Total payment records
General Amount
$13,561
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $13,327 |
| Becton, Dickinson and Company | $196 |
| Integra LifeSciences Corporation | $38 |
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: 2021-10-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20200701001613 | I | Otolaryngology | GA | TBD |
| I20210916001179 | I | General Surgery | IL | TBD |
| I20211026001357 | I | General Surgery | WI | 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 |
|---|---|---|---|---|
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 21 | 21 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 17 | 15 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 14 | 11 | $0 |
| 60500 | Removal or exploration of parathyroid glands | 14 | 14 | $0 |
| 76536 | Ultrasound scan of head and neck soft tissue | 11 | 11 | $0 |
Insurance plans in this area (ZIP 30912)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Advanced Heart Failure And Transplant Cardiology, Cardiovascular Disease (Cardiology), Cardiovascular Disease (Cardiology), Internal Medicine | WI | |
| Thoracic Surgery, Cardiac Surgery | MI | |
| Physical Therapist In Private Practice | IL | |
| - | IL | |
| Internal Medicine | WI | |
| N E U R O S U R G E R Y | IL | |
| - | WI | |
| Orthopedic Surgery | WI | |
| Physician Assistant | WI | |
| - | WI |
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