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DR. GETULIO VARGAS TOVAR M.D.
NPI 1053374082
Psychiatry & Neurology - Psychiatry in Lexington, KY

Active since April 10, 2006PECOS EnrolledAccepts Medicare Assignment
3175 CUSTER DR, SUITE #200, LEXINGTON, KY 40517(859) 273-1288(859) 273-1278 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Getulio Vargas Tovar M.d. NPPES

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

DR. GETULIO VARGAS TOVAR M.D. (NPI 1053374082) is an individual psychiatry provider in Lexington, Kentucky, licensed in Kentucky (18496) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1972).

NPPES Registry Identity

NPI1053374082
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. GETULIO VARGAS TOVARCredential: M.D.
Location Address3175 CUSTER DR, SUITE #200Lexington, KY 40517-4023
Mailing Address3175 Custer Dr, Suite #200Lexington, KY 40517-4023 · (859) 273-1288 · Fax (859) 273-1278
Phone(859) 273-1288
Fax(859) 273-1278
Sole ProprietorNo
Medical School CMSOtherGraduated 1972
Enumeration DateApril 10, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1053374082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in KY · 18496
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
3175 CUSTER DR, Lexington, KY 40517
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Other Identifiers 3

Medicaid64184963KY
Medicare ID-Type Unspecified0019503KY
Medicare UPINC64465KY

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Getulio Vargas Tovar M.d. 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 ID2264616804
PECOS Enrollment IDI20141022000776
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.

Medicare Billing Reassignment

Medicare enrollment records show Getulio Tovar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Psychological & Behavioral Consultants, LLC
287 mi
Psychiatry
25101 CHAGRIN BLVD STE 100
Beachwood, OH 44122
  • Reassigned Medicare billing, Kentucky enrollment
  • 198 clinicians in this Medicare group
NPI 1811915713 (216) 468-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

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.

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.
291 services104 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.
39 services23 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40517 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
$162.27 typical visit price
range $52.76 – $162.27
Typical copayment $40.56 (range $13.19 – $40.56)
Most-billed visit code 99205
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

PSYCHIATRIC ASSOCIATES
Psychiatry & Neurology (Psychiatry)
3175 CUSTER DR, SUITE #200
LEXINGTON, KY 40517
Fayette County (859) 273-1288
DR. MARC HENRY PLAVIN PH.D.
Psychologist
3175 CUSTER DR, SUITE #200
LEXINGTON, KY 40517
Fayette County (859) 273-1288
MR. PAUL DOUGLAS ACRA MSW, LCSW
Counselor (Mental Health)
3175 CUSTER DR
LEXINGTON, KY 40517
Fayette County (859) 273-1288
MR. PERRY BRIAN SUTTON ARNP
Nurse Practitioner (Psychiatric/Mental Health)
3175 CUSTER DR, STE 200
LEXINGTON, KY 40517
Fayette County (859) 273-1288
BEHAVIORAL HEALTH & WELLNESS CENTER
Psychiatry & Neurology (Psychiatry)
3175 CUSTER DR, SUITE 200
LEXINGTON, KY 40517
Fayette County (859) 273-1288

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Getulio Tovar's NPI number?

The NPI number for Getulio Tovar is 1053374082. It was assigned to this individual provider in the NPPES registry on April 10, 2006.

Where is Getulio Tovar located?

Getulio Tovar practices at 3175 Custer Dr Suite #200, Lexington, KY 40517. The listed phone number is (859) 273-1288.

What is Getulio Tovar's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Getulio Tovar enrolled in Medicare?

Yes. Getulio Tovar is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Getulio Tovar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Getulio Tovar reassigns Medicare benefits to Psychological & Behavioral Consultants, LLC (Beachwood, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Getulio Tovar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Getulio Tovar accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Getulio Tovar as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Getulio Tovar was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.