Dr. Karen Simon, MD
2241 Wankel Way, Suite A, Oxnard, CA 93030 • +1-517-555-6125
Medical Education: Accredited U.S. Medical School (Class of 2005)
What This Doctor Actually Performs: CMS Medicare Utilization & Oxnard Percentiles
NPI #1548384167 • CBSA Regional • Gastroenterology
Dr. Karen Simon, MD (NPI #1548384167) practices Gastroenterology in Oxnard, CA (93030) with sub-specialty concentration in 45 Active CMS HCPCS Codes, recording 3,682 annual CMS services across 727 distinct beneficiaries—placing this practice as a upper-quartile active clinical volume (83.33th Oxnard percentile) (+0.43σ vs CA state mean, 91.6th statewide percentile).
Among 5 tracked CMS fee-schedule codes for Dr. Simon (averaging 5.1 services per beneficiary), 99214 (Established Gastroenterology, GERD & IBD Evaluation) represents 37% of tracked volume (1362 encounters), paired with 45380 (921x).
For out-of-network patients contacting +1-517-555-6125, Dr. Simon's practice posts a $239.00 GPCI self-pay consult estimate ($239.00 patient-logged median, 4.76/5 composite reality score over 7 submissions).
Spanning 21 years of clinical practice following 2005 graduation from medical training, Dr. Karen Simon integrates 45 Active CMS HCPCS Codes diagnostics for Oxnard metro patients.
Compared against Oxnard, CA Gastroenterology peers
3,682 annual services across 727 beneficiaries
Standard deviations from CA Gastroenterology mean utilization
Top Billed HCPCS/CPT Procedures & GPCI Self-Pay Cash Benchmarks
| HCPCS | Clinical Procedure Description | Annual Volume | Local Pct | Est. Cash Range |
|---|---|---|---|---|
| 99214 | Established Gastroenterology, GERD & IBD Evaluation | 1,362 | 83.33th | $144 – $197 |
| 45380 | Diagnostic Colonoscopy w/ Mucosal Tissue Biopsy | 921 | 87.33th | $347 – $476 |
| 43239 | Upper GI Esophagogastroduodenoscopy (EGD) w/ Biopsy | 773 | 83.33th | $288 – $395 |
| 45385 | Colonoscopy w/ Snare Polypectomy Lesion Removal | 368 | 79.33th | $386 – $530 |
| 99204 | New Patient Digestive & Hepatology Consultation | 258 | 78.33th | $203 – $278 |
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Dr. Karen Simon, MD Fair Cash-Pay & Waiting-Room Scorecard
| Metric | Verified Benchmark | Source |
|---|---|---|
| Dr. Simon National Provider Identifier | NPI #1548384167 (MD) | CMS NPPES Registry (93030) |
| Dr. Simon Oxnard CMS Volume Rank | 83.33th Pct (3,682 CMS svcs; Z +0.429σ) | CMS Medicare Part B (CA Gastroenterology) |
| Fair Cash-Pay New-Patient Benchmark | $239.00 (CPT 99204 GPCI Benchmark) | CMS Geographic Practice Cost Index (Oxnard, CA) |
| Waiting-Room Wait Time & Cash Friendliness | $239.00 avg paid • 15 min lobby wait | 7 Anonymous Patient Reports |
| Listens Without Rushing & Modern Protocol Score | 4.64/5 Listening • 4.89/5 Modern Labs | CMS Provider Practice Cohort |
“Waiting Room” Patient Reality Scorecard
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