Dr. Kenneth Simons , MD
Ophthalmology • Milwaukee, WI
925 N 87th St, The Eye Institute
Milwaukee, WI 532264812
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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NPI assigned on May 12, 2006; this date does not establish years in practice.
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Published CMS data list 146 Original Medicare Part B services in 2022.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2022. Published rows only; this is not a quality measure.
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Published Part B service records, 2022:
- 92014 — Established patient complete exam of visual system: 96 service units.
- 92004 — New patient complete exam of visual system: 22 service units.
- 92083 — Exam of visual field with extended testing: 17 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2022. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2021 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2022). CPT notice
See all 4 records in the table · Guide: How to read Medicare Part B data
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Published CMS data list 17 Medicare Part D prescriptions, including refills, in 2022.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2022. Published rows only; this is not a quality measure.
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Published Part D records, 2022:
- Latanoprost — 17 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2022. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See the full table · Guide: How to read Medicare Part D prescriber data
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Medicare Part B services went from 147 in 2018 to 146 in 2022.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2018–2022.
Practice Location & Contact Primary Location
925 N 87th St
The Eye Institute
Milwaukee, WI 532264812
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Ophthalmology: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
127 people with Original Medicare in 2022
It gives a sense of how many people with Medicare this clinician treated that year.
Source: CMS, Medicare Physician & Other Practitioners – by Provider, 2022.
Medicare-allowed amount
About $9,778 in 2022
The total amount Medicare approved for these services in 2022. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2022.
Paid by Medicare
About $5,710 in 2022
The part of the Medicare-allowed amount that Medicare itself paid in 2022, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2022.
30-day fills
42 standardized 30-day fills in 2022
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$341 in 2022
The total cost of these prescriptions in 2022, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2022.
Industry payments (Open Payments)
No Open Payments records are listed for this clinician for 2019–2025.
NPI first issued
2006
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Can order Medicare-covered services
CMS lists Dr. Simons as eligible to order or refer durable medical equipment (DME) for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Milwaukee and Wisconsin
Billing and prescribing volume is not a quality rating.
Medicare Part B
Comparisons use 2024 data. The latest CMS data for Dr. Simons are from 2022.
Medicare Part D
Comparisons use 2024 data. The latest CMS data for Dr. Simons are from 2022.
75 active clinicians are listed under Ophthalmology with a practice address in Milwaukee, WI (445 in Wisconsin).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Milwaukee
0% of these 75 clinicians have the CMS telehealth indicator.
50.7% of these 75 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services stayed about the same: 147 in 2018 and 146 in 2022.
- 2018: 147
- 2019: 146
- 2020: 144
- 2021: 172
- 2022: 146
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Medicare-allowed amount
Medicare-allowed amount increased 14% from $8,561 in 2018 to $9,778 in 2022.
- 2018: $8,561
- 2019: $8,911
- 2020: $10,802
- 2021: $12,649
- 2022: $9,778
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Paid by Medicare
Paid by Medicare increased 15% from $4,985 in 2018 to $5,710 in 2022.
- 2018: $4,985
- 2019: $5,883
- 2020: $6,816
- 2021: $7,841
- 2022: $5,710
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Medicare Part D prescriptions
Medicare Part D prescriptions decreased 45% from 31 in 2017 to 17 in 2022.
- 2017: 31
- 2018: 29
- 2019: 17
- 2021: 15
- 2022: 17
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30-day fills
30-day fills varied from year to year: 45 in 2017 and 42 in 2022.
- 2017: 45
- 2018: 43
- 2019: 37
- 2021: 31
- 2022: 42
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Part D drug cost
Part D drug cost decreased 96% from $7,726 in 2017 to $341 in 2022.
- 2017: $7,726
- 2018: $7,529
- 2019: $654
- 2021: $423
- 2022: $341
Sources: CMS Medicare Physician & Other Practitioners (2022), CMS Medicare Part D Prescribers (2022), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Performed Procedures & Service Volume
CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016–2021 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2017–2022; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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92014
Established patient complete exam of visual system
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96 | 92 | $259.00 | $73.63 |
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92004
New patient complete exam of visual system
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22 | 22 | $323.00 | $92.75 |
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92083
Exam of visual field with extended testing
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17 | 16 | $288.00 | $26.12 |
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92250
Photography of the retina
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11 | 11 | $438.00 | $20.42 |
Source: CMS Part B by Provider and Service, 2022; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2022.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Latanoprost | Latanoprost | 17 | 1,245 | $341.39 | — |
Source: CMS Part D by Provider and Drug, 2022; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
NUCC Taxonomy Code: 207W00000X
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
NUCC Taxonomy Code: 207ZP0101X
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Additional State Medicaid & Healthcare Payer Identifiers
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSSources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Ophthalmology
Doctor of Medicine (M.D.)
Ophthalmology - Retina Specialist
Doctor of Medicine (M.D.), Doctor of Philosophy (Ph.D.)
Ophthalmology
Doctor of Medicine (M.D.)
Ophthalmology
Doctor of Medicine (M.D.)
Ophthalmology
Doctor of Medicine (M.D.)
Ophthalmology
Career & Practice History
NPI enumerated May 12, 2006.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to November 2026.
NPI Administrative Meta
Other Ophthalmology Specialists in Milwaukee
- Dr. Tina Damarjian, MD
- Dr. Joon-Bom Kim, MD
- Dr. David Weinberg, MD
- Anthony Jones
- Dr. Marc Hirsch, MD
- Dr. Siyang Chaili, MD
Mailing Address
925 N 87th St, The Eye Institute
Milwaukee, WI 532264812
Phone: 4149552020