SIQIN LUO SIMMONS – Psychiatric/Mental Health Clinical Nurse Specialist, NPI 1578128443
Psychiatric/Mental Health Clinical Nurse Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SIQIN LUO SIMMONS
4460, Highland Drive, Millcreek, Salt Lake County, Utah, 84124, United States
SALT LAKE CITY, UT 841243543
Phone: (888) 949-4864
Type: Mailing
672 W 400 S Ste 201
Springville, UT 846633170
Phone: (801) 369-8989
Fax: (801) 704-9741
Type: Location
4460 S Highland Dr
Salt Lake City, UT 841243543
Phone: (888) 949-4864
Type: Location
672 W 400 S STE 201
SPRINGVILLE, UT 846633170
Phone: (801) 369-8989
Fax: (801) 704-9741
Type: Mailing
PO BOX 27128
SALT LAKE CITY, UT 841270128
Phone: (801) 369-8989
Fax: (801) 704-9741
Type: Mailing
5770 S 1500 W
SALT LAKE CITY, UT 841235216
Phone: (801) 265-3412
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $294.
Total Amount is formed as General ($294) + Research ($0) + Ownership ($0) = $294.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($149).
Total Amount
$294
General + Research + Ownership
Payments
4
Total payment records
General Amount
$294
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $149 |
| ITI, Inc. | $125 |
| Braeburn Inc. | $20 |
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: 2021-02-17
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 |
|---|---|---|---|---|
| I20210217003047 | I | Nurse Practitioner | UT | 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 84124)
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