TOBY LEE SMITH D.O.
NPI 1124239389
Internal Medicine - Geriatric Medicine in Kailua Kona, HI

Q: What is Toby Smith's NPI number?

The NPI number for Toby Smith is 1124239389. It was assigned to this individual provider in the NPPES registry on May 26, 2007.

Q: What is Toby Smith's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Q: When was this NPI record last updated?

The NPPES record for Toby Smith was last updated on June 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 May 26, 2007PECOS EnrolledAccepts Medicare Assignment

86.2/100

CMS Quality Rating

73-4603 KALOKO LOA PL, KAILUA KONA, HI 96740(808) 489-4731 Get Directions Write a Review

NPPES record last updated: June 30, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Toby Lee Smith D.o. NPPES

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

TOBY LEE SMITH D.O. (NPI 1124239389) is an individual geriatric medicine provider in Kailua Kona, Hawaii, licensed in Hawaii (DOS 1169) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Hilo Medical Center, and maintains a secondary practice location in Kailua Kona.

NPPES Registry Identity

NPI1124239389

Entity TypeIndividualMale

Primary Taxonomy207RG0300X

Provider Legal NameTOBY LEE SMITHCredential: D.O.

Location Address73-4603 KALOKO LOA PLKailua Kona, HI 96740-7616

Mailing AddressPo Box 2091Dalton, GA 30722-2091 · (706) 271-0100

Phone(808) 489-4731

Sole ProprietorYes

Medical School CMSOtherGraduated 2005

Enumeration DateMay 26, 2007

Last NPPES UpdateJune 30, 2020

NPPES CertifiedJune 30, 2020

✔ NPI 1124239389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RG0300X

License✔ Licensed in HI · DOS 1169

Definition

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

Also ListedInternal MedicineTaxonomy 207R00000X · License DOS 1169 (HI)

73-4603 KALOKO LOA PL, Kailua Kona, HI 96740

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Secondary Practice Location 1

Location 178-6957 Kamehameha III RdKailua Kona, HI 96740-2528 · Phone (808) 322-2790 ext. 124 · Fax (808) 324-1750

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA.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

Toby Lee Smith D.o. 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 ID6800933912

PECOS Enrollment IDI20091022000186

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 26

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.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

349 services122 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

244 services64 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

190 services87 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

164 services70 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

151 services37 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

137 services94 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

108 services59 patients

Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional 99484

Care management for behavioral health involves a healthcare professional directing clinical staff to provide you with support for 20 minutes or more. This service can include planning your care, coordinating services, and managing your health conditions to improve your overall well-being.

89 services34 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

83 services36 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

78 services76 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

77 services72 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

68 services37 patients

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458

This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.

66 services34 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307

49 services28 patients

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment 99453

Remote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.

48 services48 patients

Nursing facility discharge management, more than 30 minutes 99316

Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.

45 services43 patients

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) G0506

This service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.

40 services40 patients

Psychiatric diagnostic evaluation 90791

A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.

29 services16 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

28 services28 patients

Psychiatric diagnostic evaluation with medical services 90792

A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.

21 services21 patients

Initial psychiatric collaborative care management, first calendar month, first 70 minutes 99492

This is the first month of a mental health care program where a team of health professionals collaboratively manage your care. The first 70 minutes involve assessing your needs, creating a care plan, and coordinating services to support your mental wellbeing.

20 services20 patients

Psychiatric diagnostic evaluation with medical services 90792

17 services17 patients

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment 99453

16 services16 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

13 services12 patients

Advance care planning, first 30 minutes 99497

13 services13 patients

Nursing facility discharge day management, 30 minutes or less 99315

Nursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Hilo Medical Center

Acute Care Hospitals · Hilo, HI

2/5 CMS rating

OwnershipGovernment - State

CMS Certification Number120005

Location1190 Waianuenue AvenueHilo, HI 96720 · Hawaii County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96740 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

$180.05 typical visit price

range $60.53 – $180.05

Typical copayment $45.01 (range $15.13 – $45.01)

Most-billed visit code 99205

Established Patient

$105.65 typical visit price

range $20.09 – $147.56

Typical copayment $26.41 (range $5.02 – $36.89)

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.

86.2/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

80.28

Promoting Interoperability

100

Improvement Activities

Cost

73.72

Reported Quality Measures

Diabetes: Foot Exam

The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year

40%135 patients2/55-star benchmark: 98%

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

47%135 patients2/55-star benchmark: 99%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

48%737 patients2/55-star benchmark: 99%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

34%739 patients2/55-star benchmark: 90%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients tobacco: 44% · 594 patients

44%594 patients

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.

Other Providers at the Same Location NPPES

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

TOBY L SMITH DO

Internal Medicine

73-4603 KALOKO LOA PL
KAILUA KONA, HI 96740

Hawaii County (808) 489-4731

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 Toby Smith's NPI number?

The NPI number for Toby Smith is 1124239389. It was assigned to this individual provider in the NPPES registry on May 26, 2007.

Where is Toby Smith located?

Toby Smith practices at 73-4603 Kaloko Loa Pl, Kailua Kona, HI 96740. The listed phone number is (808) 489-4731.

What is Toby Smith's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Is Toby Smith enrolled in Medicare?

Yes. Toby Smith 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.

What insurance does Toby Smith accept?

Health plans from HMSA list Toby Smith 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.

Is Toby Smith affiliated with any hospitals?

According to CMS data, Toby Smith is affiliated with Hilo Medical Center.

When was this NPI record last updated?

The NPPES record for Toby Smith was last updated on June 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.