DOUGLAS PAUL SIMON (PA-C) – Physician Assistant, NPI 1023361128

DOUGLAS PAUL SIMON (PA-C) is a healthcare provider. based in Goodland, Kansas. specializing in Physician Assistant. They hold the professional credentials PA-C. They hold a License No. 15-01575 (KS). The NPI Number for DOUGLAS PAUL SIMON (PA-C) is 1023361128

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
DOUGLAS PAUL SIMON (PA-C)
NPI
1023361128
Phone
(785) 890-6075
Address
106 WILLOW RD
Enumeration Date
26 October 2012
Last Update Date
26 October 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6027651450
Graduation Year
2012 (14 years ago)
PAC ID
0648400689
Group Practice PAC ID
4789595844
Professional Enrollment ID
I20140313000353
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

Provider Addresses for DOUGLAS PAUL SIMON (PA-C)

  • 106 WILLOW RD

    GOODLAND, KS 677351518

    Phone: (785) 890-6075

    Fax: (785) 890-6077

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2024-06-14 • Largest payer in this snapshot: Novo Nordisk Inc ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-14

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Novo Nordisk Inc$14
View all Open Payments →|Open Payments Risk Radar →

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: 2022-05-04

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140313000353IPhysician AssistantKSTBD
I20220504002025IPhysician AssistantIATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 67735)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789595844View full group profile

Reviews

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Frequently asked questions

What NPI should I save for DOUGLAS PAUL SIMON (PA-C)?
Save NPI 1023361128 if you need a stable reference for DOUGLAS PAUL SIMON (PA-C).
Is DOUGLAS PAUL SIMON (PA-C) active in the national directory?
DOUGLAS PAUL SIMON (PA-C)'s public NPI profile is in an active state.
What does DOUGLAS PAUL SIMON (PA-C) treat or focus on?
Patients typically see DOUGLAS PAUL SIMON (PA-C) under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
What location metadata exists for DOUGLAS PAUL SIMON (PA-C)?
The page summarizes Goodland, Kansas for DOUGLAS PAUL SIMON (PA-C); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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