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DR. TODD N TOM MD
NPI 1154327559
Surgery in South Williamson, KY

Active since June 22, 2005PECOS EnrolledAccepts Medicare Assignment
306 HOSPITAL DR STE 100, SOUTH WILLIAMSON, KY 41503(606) 237-1789(606) 237-1797 Get Directions Write a Review

NPPES record last updated: May 21, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Todd N Tom Md NPPES

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

DR. TODD N TOM MD (NPI 1154327559) is an individual surgery provider in South Williamson, Kentucky, licensed in Kentucky (39872) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Southern Regional Medical Center, and is a graduate of Other (1983).

NPPES Registry Identity

NPI1154327559
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. TODD N TOMCredential: MD
Location Address306 HOSPITAL DR STE 100South Williamson, KY 41503-4095
Mailing Address306 Hospital Dr Ste 100South Williamson, KY 41503-4095 · (606) 237-1789 · Fax (606) 237-1797
Phone(606) 237-1789
Fax(606) 237-1797
Sole ProprietorNo
Medical School CMSOtherGraduated 1983
Enumeration DateJune 22, 2005
Last NPPES UpdateMay 21, 2020
NPPES CertifiedMay 21, 2020
✔ NPI 1154327559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in KY · 39872
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
306 HOSPITAL DR STE 100, South Williamson, KY 41503
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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

Dr. Todd N Tom 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 ID8820005333
PECOS Enrollment IDI20211210000616
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 5

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.
63 services22 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.
35 services18 patients
Removal of skin and tissue, 20.0 sq cm or less 11042
This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
27 services11 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.
27 services15 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
22 services21 patients

Hospital Affiliations CMS Care Compare

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

Southern Regional Medical Center

Acute Care Hospitals · Riverdale, GA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110165
Location11 Upper Riverdale Road, SWRiverdale, GA 30274 · Clayton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41503 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
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 4

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

DR. CHADWICK J KNIGHT MD
Surgery
306 HOSPITAL DR STE 100
SOUTH WILLIAMSON, KY 41503
Pike County (606) 237-1789
DR. MKAYLA NICOLE FRANCIS DO
Family Medicine
306 HOSPITAL DR STE 100
SOUTH WILLIAMSON, KY 41503
Pike County (606) 237-1789
AUBRY RENEE MASSEY MSN, APRN, FNP-C
Nurse Practitioner (Family)
306 HOSPITAL DR STE 100
SOUTH WILLIAMSON, KY 41503
Pike County (606) 237-1789
GARETT CHARLES FRANCIS DO
Family Medicine
306 HOSPITAL DR STE 100
SOUTH WILLIAMSON, KY 41503
Pike County (606) 237-1789

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 Todd Tom's NPI number?

The NPI number for Todd Tom is 1154327559. It was assigned to this individual provider in the NPPES registry on June 22, 2005.

Where is Todd Tom located?

Todd Tom practices at 306 Hospital Dr Ste 100, South Williamson, KY 41503. The listed phone number is (606) 237-1789.

What is Todd Tom's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Todd Tom enrolled in Medicare?

Yes. Todd Tom 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 Todd Tom accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Todd Tom 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 Todd Tom affiliated with any hospitals?

According to CMS data, Todd Tom is affiliated with Southern Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Todd Tom was last updated on May 21, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.