Medicare Enrolled
Dr. Karen Simon, M.D.
Gastroenterology · Oxnard, CA
Practice pattern: Clinical Cardiology
— Primarily office-based clinical cardiology
Low-engagement
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Simon from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Simon
Dr. Karen Simon is a gastroenterology specialist in Oxnard, CA, with 19 years of NPI registration. Based on federal Medicare data, Dr. Simon performed 3,443 Medicare services across 1,439 unique beneficiaries.
Between the years covered by Open Payments, Dr. Simon received a total of $10,752 from 42 pharmaceutical and/or device companies across 498 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in gastroenterology. Most payments are for meals and travel — low-value interactions common across virtually all practicing physicians. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Simon is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 19 years in practice
▲ Top 3% volume in CA
$10,752 industry payments
Medicare Practice Summary
Medicare Utilization ↗3,443
Medicare services
Top 3% in CA for gastroenterology
1,439
Unique beneficiaries
$71
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~181 Medicare services per year of practice
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Chronic care management, additional 20 min/month This service covers an extra 20 minutes of clinical staff time directed by a healthcare professional for managing two or more chronic conditions each calendar month. |
1,180 | $40 | $240 |
| Chronic care management, first 20 min/month This service covers the first 20 minutes of clinical staff time directed by a healthcare professional each calendar month to manage chronic conditions. |
692 | $51 | $300 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
243 | $104 | $600 |
| Upper GI endoscopy with biopsy A procedure to collect tissue samples from the esophagus, stomach, or upper small intestine using a flexible tube with a camera. The samples are examined to check for abnormalities. |
168 | $86 | $603 |
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
147 | $72 | $440 |
| Remote patient monitoring device, 30 days Initial setup of devices for remote monitoring of body functions with daily data transmission or alerts. This service covers the first 30 days of the monitoring period. |
147 | $46 | $280 |
| Hospital follow-up visit, high complexity Subsequent hospital inpatient or observation care for an existing patient involving high-level medical decision making, with at least 50 minutes total time on the date of the encounter. |
144 | $98 | $530 |
| Remote patient monitoring management, 20 min/month Management based on results from remote vital sign monitoring for the first 20 minutes per calendar month. |
128 | $42 | $240 |
| Colonoscopy with biopsy A procedure to collect tissue samples from the large intestine using a flexible tube with a camera. The samples are examined to check for abnormalities or disease. |
116 | $128 | $854 |
| New patient office visit (45-59 min) An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter. |
111 | $122 | $780 |
| Colon polyp removal with endoscopic snare This procedure removes polyps or growths from the large bowel using a flexible tube with a camera and a wire loop tool. The snare is used to cut off the growths during the examination. |
84 | $215 | $1,111 |
| New patient office visit (30-44 min) An initial office visit for a new patient lasting between 30 and 44 minutes. This code is used when the total time spent on the date of the encounter falls within this range. |
70 | $84 | $540 |
| Initial hospital admission, high complexity Initial hospital inpatient or observation care for a new patient involving high-level medical decision making, with at least 75 minutes total time on the date of the encounter. |
67 | $141 | $773 |
| Colonoscopy for colorectal cancer screening A colonoscopy performed to screen for colorectal cancer in individuals who are not at high risk for the disease. |
30 | $183 | $800 |
| Liver stiffness measurement A non-invasive test that uses ultrasound or similar technology to measure the stiffness of liver tissue. This measurement helps assess the degree of liver fibrosis or scarring. |
29 | $27 | $160 |
| Colonoscopy for colorectal cancer screening, high risk A colonoscopy performed to screen for colorectal cancer in individuals identified as being at high risk for the disease. |
27 | $182 | $791 |
| Colonoscopy A diagnostic exam of the large bowel using a flexible endoscope to visualize the interior of the colon. |
18 | $143 | $809 |
| Upper endoscopy (EGD) A diagnostic exam of the esophagus, stomach, and upper small bowel using a flexible endoscope. |
17 | $101 | $543 |
| Remote physiologic monitoring setup and education Initial setup of remote monitoring equipment and patient education on its use. |
14 | $18 | $120 |
| Endoscopy of digestive tract Imaging of the digestive tract performed from the inside using an endoscope. |
11 | $690 | $3,980 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. A higher procedure volume generally indicates more experience with that procedure.
Industry Payment Transparency
Open Payments through 2024 ↗$10,752
Total received (2018-2024)
Avg $1,536/year across 7 years
Top 18% in CA for gastroenterology
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
42
Companies
498
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →
Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$10,718 (99.7%)
Speaking / Promotional
Speaker programs, honoraria, and industry-sponsored educational events
$34 (0.3%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$2,144
2023
$1,314
2022
$1,596
2021
$1,256
2020
$1,975
2019
$1,268
2018
$1,200
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
ABBVIE INC.
$799
Janssen Biotech, Inc.
$260
PFIZER INC.
$195
Lilly USA, LLC
$158
Ardelyx, Inc.
$140
AIMMUNE THERAPEUTICS, INC.
$75
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$71
Regeneron Healthcare Solutions, Inc.
$64
Phathom Pharmaceuticals, Inc.
$60
Madrigal Pharmaceuticals
$56
IRONWOOD PHARMACEUTICALS, INC
$47
GENZYME CORPORATION
$47
Celgene Corporation
$42
Takeda Pharmaceuticals U.S.A., Inc.
$42
Celltrion USA Inc.
$34
Endogastric Solutions, Inc
$24
Intercept Pharmaceuticals, Inc.
$16
QOL Medical, LLC
$14
Top 3 companies account for 58.5% of 2024 payments
All-time payments by company (2018-2024) ›
ABBVIE INC.
$1,719
AbbVie Inc.
$1,485
Adare Pharmaceuticals, Inc.
$1,103
Janssen Biotech, Inc.
$981
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$714
PFIZER INC.
$541
Gilead Sciences, Inc.
$485
Takeda Pharmaceuticals U.S.A., Inc.
$440
AbbVie, Inc.
$429
Celgene Corporation
$231
Ardelyx, Inc.
$223
Lilly USA, LLC
$198
Synergy Pharmaceuticals Inc
$193
GENZYME CORPORATION
$141
QOL Medical, LLC
$138
Ironwood Pharmaceuticals, Inc
$125
Janssen Scientific Affairs, LLC
$125
Regeneron Healthcare Solutions, Inc.
$120
IRONWOOD PHARMACEUTICALS, INC
$113
Nestle HealthCare Nutrition Inc.
$108
E.R. Squibb & Sons, L.L.C.
$106
INTERCEPT PHARMACEUTICALS, INC.
$92
Intercept Pharmaceuticals, Inc.
$78
AIMMUNE THERAPEUTICS, INC.
$75
Daiichi Sankyo Inc.
$75
Allergan Inc.
$65
Biogen, Inc.
$61
Shionogi Inc
$60
Phathom Pharmaceuticals, Inc.
$60
Ferring Pharmaceuticals Inc.
$57
Madrigal Pharmaceuticals
$56
NESTLE HEALTHCARE NUTRITION INC.
$53
Aries Pharmaceuticals, Inc.
$46
Merck Sharp & Dohme Corporation
$44
RedHill Biopharma Inc.
$44
Celltrion USA Inc.
$34
Endogastric Solutions, Inc
$33
Merck Sharp & Dohme LLC
$33
Shire North American Group Inc
$23
Evoke Pharma, Inc.
$19
Braintree Laboratories, Inc.
$13
Alfasigma USA, Inc.
$12
Top 3 companies account for 40.1% of all-time payments
Associated products mentioned in payments ›
APRISO · Amitiza · BYVALSON · CREON · Creon · DIFICID · DUPIXENT · Dexilant · ELEVIEW · ENTYVIO · EOHILIA · ESOPHYX · Entyvio · GATTEX · GIMOTI · HUMIRA · Humira · IBSRELA · INFLECTRA · INJECTAFER · LINZESS · Linzess · MAVYRET · MOTEGRITY · Motegrity · Mulpleta · OCALIVA · OMVOH · REBYOTA · REMICADE · RENFLEXIS · RESMETIROM · RINVOQ · SIMPONI · SKYRIZI · STELARA · SUCRAID · SUPREP · Sucraid · Symproic · TREMFYA · TRULANCE · Talicia · Trulance · UCERIS TABLETS · VEGZELMA · VIBERZI · VOQUEZNA · VOWST · XELJANZ · XIFAXAN · XIFAXANIBSD · ZENPEP · ZEPOSIA · ZYMFENTRA
Should you be concerned? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Most payments (100%) are for meals and travel — low-value interactions that are common across virtually all practicing physicians.
Geographic Context
Gastroenterologists within 10 mi
27
Per 100K population
3.2
County median income
$107,327
Nearest hospital
ST JOHNS REGIONAL MEDICAL CENTER
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not public | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Simon is a clinical cardiology specialist, with above-average Medicare volume (top 3% in CA), with low-engagement industry engagement in the top 18% of CA peers, with 19 years of NPI registration.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Simon experienced with chronic care management, additional 20 min/month?
Based on Medicare claims data, Dr. Simon performed 1,180 chronic care management, additional 20 min/month services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Simon receive payments from pharmaceutical companies?
Yes. Dr. Simon received a total of $10,752 from 42 companies across 498 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Simon's costs compare to other gastroenterologists in Oxnard?
Dr. Simon's average Medicare payment per service is $71. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Simon) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating a long track record of practice, Medicare participation, and industry disclosure. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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