WANDA J SIMMONS CLEMMONS (MD) – Adult Medicine Physician, NPI 1275615775
Adult Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,488 FAMILY PRACTICE in MD
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Provider Addresses for WANDA J SIMMONS CLEMMONS (MD)
808 GLENEAGLES CT # 20069
TOWSON, MD 212862205
Phone: (443) 900-3184
Fax: (512) 559-7040
Type: Mailing
6724, Glenkirk Road, Glendale, Towson, Baltimore County, Maryland, 21239, United States
BALTIMORE, MD 212391410
Phone: (443) 803-2732
Type: Mailing
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: 2011-11-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20111118000316 | I | Family Practice | MD | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 21286)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | MD | 73562 | X-ray of knee, 3 views | 15 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | NY | |
| Hospitalist, Internal Medicine | NY | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NJ | |
| Internal Medicine, Hospitalist, Internal Medicine | FL | |
| Emergency Medicine, Family Practice, Hospitalist | OH | |
| Geriatric Medicine | KS | |
| Geriatric Medicine, Critical Care (Intensivists) | NY | |
| Pain Management, Anesthesiology, Geriatric Medicine | NJ | |
| Family Practice | NY |
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