TOBY DYLAN TERWILLIGER MD
NPI 1174058275
Hospitalist in Atlanta, GA

Active since April 26, 2017PECOS EnrolledAccepts Medicare Assignment
94.56/100
CMS Quality Rating
80 JESSE HILL JR DR SE, ATLANTA, GA 30303(585) 755-0192 Get Directions Write a Review

NPPES record last updated: August 23, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 23, 2021, Apr 26, 2021, Apr 26, 2017 (3 updates tracked since 2017).

About Toby Dylan Terwilliger Md NPPES

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

TOBY DYLAN TERWILLIGER MD (NPI 1174058275) is an individual hospitalist provider in Atlanta, Georgia, licensed in Georgia (88520) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Grady Memorial Hospital, and is a graduate of New York University School Of Medicine (2017).

NPPES Registry Identity

NPI1174058275
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameTOBY DYLAN TERWILLIGERCredential: MD
Location Address80 JESSE HILL JR DR SEAtlanta, GA 30303-3050
Mailing Address143 Maple Hill Farm RdPenfield, NY 14526-1713 · (585) 755-0192
Sole ProprietorNo
Medical School CMSNew York University School Of MedicineGraduated 2017
Enumeration DateApril 26, 2017
Last NPPES UpdateAugust 23, 20213 updates tracked since enumeration
NPPES CertifiedAugust 23, 2021
NPI 1174058275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License Licensed in GA · 88520
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 88520 (GA)
Also ListedPediatricsTaxonomy 208000000X · License 88520 (GA)
80 JESSE HILL JR DR SE, Atlanta, GA 30303

Accepted 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 Dylan Terwilliger 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 ID1759784242
PECOS Enrollment IDI20210721001846
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.

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.
78 services33 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.
58 services25 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
45 services17 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
33 services31 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.
30 services30 patients

Hospital Affiliations CMS Care Compare

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

Grady Memorial Hospital

Acute Care Hospitals · Atlanta, GA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110079
Location80 Jesse Hill, Jr Drive SEAtlanta, GA 30303 · Fulton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30303 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

94.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.49
Promoting Interoperability100
Improvement Activities40
Cost75.54

Other Providers at the Same Location NPPES 20

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

Obstetrics & Gynecology (Gynecologic Oncology)
80 JESSE HILL JR DR SE
ATLANTA, GA 30303
Internal Medicine
80 JESSE HILL JR DR SE
ATLANTA, GA 30303
Surgery (Surgical Critical Care)
80 JESSE HILL JR DR SE
ATLANTA, GA 30303
Pharmacist
80 JESSE HILL JR DR SE, GRADY HEALTH SYSTEM PHARMACY
ATLANTA, GA 30303
Pharmacist
80 JESSE HILL JR DR SE
ATLANTA, GA 30303
Pharmacist (Pharmacotherapy)
80 JESSE HILL JR DR SE, DEPARTMENT OF PHARMACY AND DRUG INFORMATION, BG002
ATLANTA, GA 30303
Clinical Nurse Specialist (Psychiatric/Mental Health)
80 JESSE HILL JR DR SE, BOX 26238
ATLANTA, GA 30303
Pharmacist (Pharmacotherapy)
80 JESSE HILL JR DR SE, DEPT. OF PHARMACY & DRUG INFORMATION
ATLANTA, GA 30303

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 Terwilliger's NPI number?

The NPI number for Toby Terwilliger is 1174058275. It was assigned to this individual provider in the NPPES registry on April 26, 2017.

Where is Toby Terwilliger located?

Toby Terwilliger practices at 80 Jesse Hill Jr Dr SE, Atlanta, GA 30303. The listed phone number is (585) 755-0192.

What is Toby Terwilliger's specialty?

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

Is Toby Terwilliger enrolled in Medicare?

Yes. Toby Terwilliger 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 Terwilliger accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Toby Terwilliger 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 Terwilliger affiliated with any hospitals?

According to CMS data, Toby Terwilliger is affiliated with Grady Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Toby Terwilliger was last updated on August 23, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.