MR. PETER K TOTHY MD
NPI 1023157278
Internal Medicine - Hematology & Oncology in Crown Point, IN

Q: What is Peter Tothy's NPI number?

The NPI number for Peter Tothy is 1023157278. It was assigned to this individual provider in the NPPES registry on February 5, 2007.

Q: What is Peter Tothy's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Peter Tothy was last updated on March 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 05, 2007PECOS EnrolledAccepts Medicare Assignment

342 E 109TH AVE, CROWN POINT, IN 46307(219) 310-2550(219) 310-2565 Get Directions Write a Review

NPPES record last updated: March 22, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Peter K Tothy Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. PETER K TOTHY MD (NPI 1023157278) is an individual hematology & oncology provider in Crown Point, Indiana, licensed in Indiana (01065693A) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS, is affiliated with Methodist Hospitals Inc, and is a graduate of Icahn School Of Medicine At Mount Sinai (1999).

NPPES Registry Identity

NPI1023157278

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameMR. PETER K TOTHYCredential: MD

Location Address342 E 109TH AVECrown Point, IN 46307-8693

Mailing Address342 E 109th AveCrown Point, IN 46307-8693 · (219) 310-2550 · Fax (219) 310-2565

Phone(219) 310-2550

Fax(219) 310-2565

Sole ProprietorNo

Medical School CMSIcahn School Of Medicine At Mount SinaiGraduated 1999

Enumeration DateFebruary 5, 2007

Last NPPES UpdateMarch 22, 2021

NPPES CertifiedMarch 22, 2021

✔ NPI 1023157278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in IN · 01065693A

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

342 E 109TH AVE, Crown Point, IN 46307

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Other Identifiers 1

Medicaid200911390IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Peter K Tothy Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698705242

PECOS Enrollment IDI20080912000083

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 68

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, pembrolizumab, 1 mg J9271

Pembrolizumab is a medication given via injection to help your body's immune system fight certain types of cancer. It's typically administered in a hospital or clinic by a healthcare professional.

25,400 services24 patients

Injection, aprepitant, 1 mg J0185

Aprepitant injection is a medication used to prevent nausea and vomiting caused by chemotherapy. It works by blocking certain substances in the brain that trigger these symptoms. The dosage is based on your medical condition and response to treatment.

24,700 services31 patients

Injection, oxaliplatin, 0.5 mg J9263

Oxaliplatin is a chemotherapy drug that is administered via injection. It works by stopping cancer cells from growing and dividing, which helps in the treatment of certain types of cancer. The dosage is 0.5 mg, and it's important to follow your doctor's instructions for this treatment.

18,880 services14 patients

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

10,020 services42 patients

Injection, ferric derisomaltose, 10 mg J1437

Ferric derisomaltose is an iron replacement product. It's given as an injection to treat iron deficiency anemia, a condition where the body lacks enough iron. The injection helps increase iron in your body to healthy levels.

6,900 services51 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

2,774 services510 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

2,624 services474 patients

Injection, palonosetron hcl, 25 mcg J2469

Palonosetron HCL is an injection used to prevent nausea and vomiting caused by chemotherapy. It works by blocking a natural substance (serotonin) in the body that can cause vomiting. This helps improve your comfort during cancer treatment.

2,549 services38 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

2,330 services37 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

2,301 services574 patients

Blood potassium level 84132

A blood potassium level test measures the amount of potassium in your blood. Potassium is a vital mineral for the body, helping nerves and muscles, especially the heart, to function properly. Abnormal levels can cause health issues like irregular heartbeat, muscle weakness, or numbness.

2,035 services417 patients

Calcium level, total 82310

A total calcium level test measures the amount of calcium in your blood. Calcium is essential for body functions like bone formation, nerve signal transmission, and muscle contraction. Abnormal levels may indicate conditions like bone disease or kidney disorders.

2,023 services417 patients

Blood sodium level 84295

A blood sodium level test measures the amount of sodium, a vital mineral, in your blood. It helps assess your body's water levels and the function of your nerves and muscles. Abnormal levels may indicate conditions like dehydration, kidney disease, or hormonal imbalances.

2,023 services416 patients

Blood chloride level 82435

A blood chloride level test measures the amount of chloride, a type of electrolyte, in your blood. Electrolytes help balance the amount of fluids in your body and maintain your body's acid-base balance. This test can help diagnose health issues like kidney diseases, liver diseases, and heart failure.

2,022 services416 patients

Phosphatase (enzyme) level, alkaline 84075

The Alkaline Phosphatase Level test measures the amount of alkaline phosphatase, an enzyme, in your blood. High or low levels can indicate a variety of health conditions, such as liver disease or bone disorders. It's a common test done to help diagnose and monitor these conditions.

2,019 services415 patients

Bilirubin level, total 82247

A total bilirubin level test is a blood test that helps check how well your liver is functioning. It measures bilirubin, a yellow substance your body creates when it breaks down red blood cells. High levels may indicate a problem with your liver or bile duct.

2,018 services415 patients

Blood creatinine level 82565

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

2,018 services417 patients

Liver enzyme (sgpt), level 84460

A liver enzyme (SGPT) level test is a blood test that checks the health of your liver. SGPT is an enzyme found in your liver cells. If your liver is damaged or inflamed, SGPT can leak into your bloodstream, raising the enzyme level. This test helps identify liver diseases early.

2,014 services414 patients

Albumin (protein) level 82040

The Albumin Level test measures the amount of albumin, a vital protein made by the liver, in your blood. This protein helps keep fluid in your bloodstream so it doesn't leak into other tissues. It's also vital for tissue growth and healing. Low or high levels can indicate certain health issues.

2,013 services414 patients

Liver enzyme (sgot), level 84450

A Liver Enzyme (SGOT) Level test is a simple blood test used to measure the amount of certain enzymes in your blood. These enzymes are normally found in liver cells. If the liver is damaged or diseased, these enzymes can leak into your bloodstream, indicating potential liver issues.

2,013 services414 patients

Urea nitrogen level to assess kidney function, quantitative 84520

The urea nitrogen level test is a routine blood test that checks the amount of urea nitrogen in your blood to evaluate how well your kidneys are working. If the levels are higher than normal, it may indicate that your kidneys are not functioning properly.

2,009 services415 patients

Total protein level, blood 84155

A total protein level blood test measures the amount of proteins in your blood. Proteins are essential for body functions, including immune response, tissue repair, and nutrient transportation. Abnormal levels may indicate certain diseases or conditions. It's a simple test involving a blood draw.

2,006 services413 patients

Injection, leucovorin calcium, per 50 mg J0640

Leucovorin calcium is an injection given to enhance the effectiveness of certain cancer treatments or to reduce the harmful effects of some medications. The dose is determined by your doctor and is typically administered in a healthcare setting.

1,797 services18 patients

Injection, granisetron hydrochloride, 100 mcg J1626

Granisetron hydrochloride is an anti-nausea medication given by injection. It helps prevent nausea and vomiting often caused by cancer treatments like chemotherapy. Its dosage is measured in micrograms (mcg).

1,580 services21 patients

Injection, fluorouracil, 500 mg J9190

Fluorouracil is a chemotherapy drug, given as an injection to treat various types of cancer. The 500 mg dose helps to stop cancer cells from growing and multiplying. You might feel some side effects, but these are typically manageable.

1,296 services19 patients

Gammaglobulin (immune system protein) measurement 82784

Gammaglobulin measurement is a blood test that checks the levels of certain proteins (gammaglobulins) that the body uses to fight infections. High or low levels can indicate various health conditions. It's a simple, quick procedure with minimal discomfort.

799 services66 patients

Injection of additional new drug or substance into vein 96375

This procedure involves introducing a new medication or substance into your bloodstream via a vein. It's typically done using a small needle. The substance can help treat various conditions or assist in diagnostic procedures. It's generally safe and monitored by professionals.

758 services63 patients

Ferritin (blood protein) level 82728

A Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.

604 services262 patients

Administration of chemotherapy into vein, 1 hour or less 96413

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

601 services81 patients

Iron level 83540

An iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.

597 services261 patients

Iron binding capacity 83550

Iron binding capacity is a blood test that measures how well your body can bind and transport iron. This helps your healthcare provider assess if your body has too little or too much iron, which can indicate certain health conditions.

594 services259 patients

Blood glucose (sugar) level 82947

A blood glucose level test measures the amount of sugar in your blood. It's often used to monitor and manage conditions like diabetes. High or low levels can indicate a health issue. The test is usually done by pricking your finger for a small blood sample.

565 services106 patients

Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg J9201

Gemcitabine hydrochloride is a medication given via injection to treat certain types of cancer. The 200 mg dose is administered by a healthcare professional. The drug works by slowing or stopping the growth of cancer cells in the body. It's important to follow your doctor's instructions while receiving this treatment.

523 services11 patients

Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less 96367

This procedure involves injecting fluids or medication directly into your vein. It's used for treatment, prevention, or diagnosis. An additional sequential infusion may be given within an hour if needed. This helps to ensure the medicine is distributed effectively in your body.

488 services55 patients

Cyanocobalamin (vitamin b-12) level 82607

A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.

411 services216 patients

Lactate dehydrogenase (enzyme) level 83615

A Lactate Dehydrogenase level test measures the amount of this enzyme in your body. It's often done when tissue damage is suspected, as high levels can indicate issues like heart disease, lung disease, liver disease, or blood disorders. This test helps in diagnosing and monitoring these conditions.

410 services128 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

408 services166 patients

Folic acid level, serum 82746

A Folic Acid Level, Serum test measures the amount of folic acid, a type of B vitamin, in your blood. This vitamin is important for cell growth and development. It's crucial for your body to function well. If your levels are low, it may indicate a deficiency, which can lead to health issues.

398 services210 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

323 services89 patients

Injection, carboplatin, 50 mg J9045

Carboplatin is a chemotherapy drug used to treat various types of cancer by slowing or stopping the growth of cancer cells. The 50 mg injection is administered into a vein by a healthcare professional. Side effects may occur.

284 services12 patients

Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle 96401

This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.

237 services12 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

229 services86 patients

Administration of additional new drug or substance into vein, 1 hour or less 96417

This procedure involves introducing a new drug or substance into your vein, typically via an IV drip. It lasts for an hour or less. This method allows the substance to quickly reach your bloodstream, ensuring rapid and effective treatment.

229 services41 patients

Irrigation of implanted venous access drug delivery device 96523

Irrigation of an implanted venous access drug delivery device is a procedure to clean or unblock the device. This device is implanted under your skin to allow easy, frequent, and long-term access to your veins for medication delivery. The process involves flushing the device with a sterile solution to ensure it works properly.

218 services74 patients

Administration of chemotherapy into vein, each additional hour 96415

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

210 services37 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

171 services68 patients

Carcinoembryonic antigen (cea) protein level 82378

Carcinoembryonic Antigen (CEA) protein level is a blood test often used in cancer care. It measures the amount of CEA protein in your blood, which can increase in cases of certain types of cancer. It's used to monitor treatment progress and check for cancer recurrence.

156 services64 patients

Uric acid level, blood 84550

A blood uric acid level test measures the amount of uric acid in your blood. Uric acid is a waste product that your body produces when it breaks down purines, substances found in your body and in certain foods. High levels may lead to gout or kidney stones.

155 services40 patients

Injection, diphenhydramine hcl, up to 50 mg J1200

Diphenhydramine HCL injection is a medicine given to alleviate symptoms of allergies, colds, or hay fever. It can also help with motion sickness and certain symptoms of Parkinson's disease. Up to 50 mg may be administered depending on your condition.

155 services27 patients

Magnesium level 83735

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

141 services29 patients

Beta-2 microglobulin (protein) level 82232

The Beta-2 microglobulin level test measures the amount of this protein in your blood. It's often used to check kidney function or monitor certain cancers. High levels may indicate a health issue. The test involves a simple blood draw.

138 services39 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

137 services137 patients

Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l G0498

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. In the office, a pump is used to start an intravenous infusion of these drugs. The infusion can then be continued at home or another setting, like a rest home.

125 services18 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

121 services39 patients

Infusion into a vein for therapy, prevention, or diagnosis concurrent with another infusion 96368

An infusion into a vein is a method of delivering medication, nutrients, or fluids directly into your bloodstream. If it's concurrent with another infusion, it means two different solutions are given at the same time. This can be for treatment, prevention, or diagnostic purposes.

113 services22 patients

Unclassified drugs J3490

Unclassified drugs are medications that don't fit into an existing category or class due to their unique properties or uses. They may be used for various conditions and their effects may differ widely. Always ask your healthcare provider for more information about these drugs.

111 services18 patients

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

73 services21 patients

Administration of additional new drug or substance into vein using push technique 96411

This procedure involves injecting a new medication or substance directly into your vein using a method called the 'push' technique. It's a quick way to deliver medication into your bloodstream for fast-acting relief or treatment.

71 services16 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

69 services57 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

67 services18 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

57 services16 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

56 services28 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

55 services52 patients

Infusion into a vein for therapy, prevention, or diagnosis, each additional hour 96366

This procedure involves delivering medication, fluids, or nutrients directly into your vein. This is done to treat, prevent, or diagnose various conditions. Each additional hour refers to the extended time you may need to receive these substances for optimal results.

52 services13 patients

Infusion into a vein for hydration, 31-60 minutes 96360

This is a procedure where a sterile solution is administered into your vein to help restore body fluid balance. It typically lasts between 31-60 minutes. It's a safe, common treatment for dehydration or to deliver medication.

40 services17 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test 85027

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

39 services24 patients

Infusion into a vein for hydration, each additional hour 96361

This procedure involves delivering fluids directly into your vein to keep your body hydrated. It is typically done when oral hydration is insufficient. Each additional hour means more fluid is infused to ensure adequate hydration.

27 services11 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

16 services13 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Methodist Hospitals Inc

Acute Care Hospitals · Gary, IN

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150002

Location600 Grant StGary, IN 46402 · Lake County

Emergency services Birthing friendly

St Mary Medical Center Inc

Acute Care Hospitals · Hobart, IN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150034

Location1500 S Lake Park AveHobart, IN 46342 · Lake County

Emergency services Birthing friendly

Community Hospital

Acute Care Hospitals · Munster, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150125

Location901 Macarthur BlvdMunster, IN 46321 · Lake County

Emergency services Birthing friendly

Franciscan Health Crown Point

Acute Care Hospitals · Crown Point, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number150126

Location12750 Saint Francis DriveCrown Point, IN 46307 · Lake County

Emergency services Birthing friendly

Pinnacle Hospital

Acute Care Hospitals · Crown Point, IN

OwnershipPhysician

CMS Certification Number150166

Location9301 Connecticut DrCrown Point, IN 46307 · Lake County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46307 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$161.76 typical visit price

range $53.07 – $161.76

Typical copayment $40.44 (range $13.26 – $40.44)

Most-billed visit code 99205

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

98%615 patients4/55-star benchmark: 100%

Clinical Information Reconciliation

For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.

89%56 patients4/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred

85%26 patients4/55-star benchmark: 95%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

91%3,448 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

75%171 patients3/55-star benchmark: 100%

Oncology: Medical and Radiation - Pain Intensity Quantified

Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified

90%1,087 patients3/55-star benchmark: 100%

Oncology: Medical and Radiation - Plan of Care for Pain

Percentage of visits for patients, regardless of age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy who report having pain with a documented plan of care to address pain

100%275 patients5/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…

93%560 patients4/55-star benchmark: 100%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

86%397 patients4/55-star benchmark: 88%

Provide Patient Access

For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…

95%560 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…

29%560 patients2/55-star benchmark: 77%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 615 patients

1%615 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type L8000

DME-Orthotic Devices · category DF000N

3 suppliers15 claims36 services$34.94 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JODY ADAMS NP

Nurse Practitioner (Adult Health)