DR. TODD E HELTON M.D., PHD.
NPI 1194701425
Internal Medicine in Raleigh, NC

Q: What is Todd Helton's NPI number?

The NPI number for Todd Helton is 1194701425. It was assigned to this individual provider in the NPPES registry on December 19, 2005.

Q: What is Todd Helton's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Todd Helton was last updated on May 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 December 19, 2005PECOS EnrolledAccepts Medicare Assignment

2417 ATRIUM DR STE 250, RALEIGH, NC 27607(919) 781-9650(919) 781-3572 Get Directions Write a Review

NPPES record last updated: May 10, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Todd E Helton M.d., Phd. NPPES

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

DR. TODD E HELTON M.D., PHD. (NPI 1194701425) is an individual internal medicine provider in Raleigh, North Carolina, licensed in North Carolina (200000228) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Unc Hospitals, and is a graduate of Brody School Of Medicine At East Carolina University (1998).

NPPES Registry Identity

NPI1194701425

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. TODD E HELTONCredential: M.D., PHD.

Location Address2417 ATRIUM DR STE 250Raleigh, NC 27607-6673

Mailing Address2000 Perimeter Park Dr Ste 200Morrisville, NC 27560-8442

Phone(919) 781-9650

Fax(919) 781-3572

Sole ProprietorNo

Medical School CMSBrody School Of Medicine At East Carolina UniversityGraduated 1998

Enumeration DateDecember 19, 2005

Last NPPES UpdateMay 10, 2021

NPPES CertifiedMay 10, 2021

✔ NPI 1194701425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NC · 200000228

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2417 ATRIUM DR STE 250, Raleigh, NC 27607

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Other Identifiers 2

Medicaid89128MANC

Other2321358NC · Medicare Group#

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, UnitedHealthcare.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 E Helton M.d., Phd. 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 ID6709985849

PECOS Enrollment IDI20101111001096

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 17

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.

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

322 services169 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

300 services168 patients

Liver function blood test panel 80076

A liver function blood test panel helps check the health of your liver. It measures various proteins, liver enzymes, and bilirubin in your blood. If these levels are too high or too low, it could signal a liver problem. It's a simple, non-invasive test that involves drawing blood.

296 services169 patients

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.

294 services137 patients

Thyroxine (thyroid chemical), free 84439

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

269 services167 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

268 services167 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

244 services158 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.

210 services105 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

141 services141 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

120 services71 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

81 services76 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

48 services23 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

41 services41 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

36 services17 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

32 services11 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

16 services16 patients

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

15 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Unc Hospitals

Acute Care Hospitals · Chapel Hill, NC

5/5 CMS rating

OwnershipGovernment - State

CMS Certification Number340061

Location101 Manning DriveChapel Hill, NC 27514 · Orange County

Emergency services Birthing friendly

Rex Hospital

Acute Care Hospitals · Raleigh, NC

5/5 CMS rating

OwnershipGovernment - State

CMS Certification Number340114

Location4420 Lake Boone TrailRaleigh, NC 27607 · Wake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27607 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

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

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.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers17 claims69 services$6.21 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604