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DR. TOKS E MACARTHY MD
NPI 1164608964
Hospitalist in West Allis, WI

Active since January 11, 2008PECOS EnrolledAccepts Medicare Assignment
1701 WEST LINCOLN AVENUE, WEST ALLIS, WI 53227(414) 328-6000 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 24, 2025, Mar 27, 2025, Jan 17, 2018 (3 updates tracked since 2018).

About Dr. Toks E Macarthy Md NPPES

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

DR. TOKS E MACARTHY MD (NPI 1164608964) is an individual hospitalist provider in West Allis, Wisconsin, licensed in Kentucky (C3603) and active in the NPI registry since January 2008. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1164608964
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameDR. TOKS E MACARTHYCredential: MD
Location Address1701 WEST LINCOLN AVENUEWest Allis, WI 53227
Mailing Address1701 West Lincoln AvenueWest Allis, WI 53227 · (414) 328-6000
Phone(414) 328-6000
Sole ProprietorNo
Medical School CMSPennsylvania State University College Of MedicineGraduated 2005
Enumeration DateJanuary 11, 2008
Last NPPES UpdateAugust 25, 20253 updates tracked since enumeration
NPPES CertifiedAugust 25, 2025
✔ NPI 1164608964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
Licenses✔ Licensed in KY · C3603✔ Licensed in AL · MD.42216✔ Licensed in NY · 306122✔ Licensed in IL · 036123996
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 73125 (GA), C3603 (KY), MD.42216 (AL)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 51926 (WI)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1701 WEST LINCOLN AVENUE, West Allis, WI 53227
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11401 Harrodsburg RdLexington, KY 40504-3751 · Phone (859) 258-6784
Location 23579 Highway 138 SE Ste 103Stockbridge, GA 30281-4127 · Phone (770) 629-4374 · Fax (678) 545-1735

Other Identifiers 1

Medicaid7100257700KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama.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. Toks E Macarthy 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 ID2264509041
PECOS Enrollment IDI20250407002682, I20250829002903
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 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.

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.
127 services123 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.
25 services11 patients

Hospital Affiliations CMS Care Compare

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

Saint Joseph Hospital

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180010
LocationOne Saint Joseph DriveLexington, KY 40504 · Fayette County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53227 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

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 Toks Macarthy's NPI number?

The NPI number for Toks Macarthy is 1164608964. It was assigned to this individual provider in the NPPES registry on January 11, 2008.

Where is Toks Macarthy located?

Toks Macarthy practices at 1701 West Lincoln Avenue, West Allis, WI 53227. The listed phone number is (414) 328-6000.

What is Toks Macarthy's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Toks Macarthy enrolled in Medicare?

Yes. Toks Macarthy 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 Toks Macarthy accept?

Health plans from Blue Cross and Blue Shield of Alabama list Toks Macarthy 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 Toks Macarthy affiliated with any hospitals?

According to CMS data, Toks Macarthy is affiliated with Saint Joseph Hospital.

When was this NPI record last updated?

The NPPES record for Toks Macarthy was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.