TODD D GWIN MD
NPI 1225030208
Ophthalmology in Boiling Springs, SC

Active since August 10, 2005PECOS EnrolledAccepts Medicare Assignment
97.79/100
CMS Quality Rating
1520 BOILING SPRINGS RD, BOILING SPRINGS, SC 29316(864) 583-6381(864) 583-5337 Get Directions Write a Review

NPPES record last updated: August 22, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Todd D Gwin Md NPPES

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

TODD D GWIN MD (NPI 1225030208) is an individual ophthalmology provider in Boiling Springs, South Carolina, licensed in South Carolina (14232) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Spartanburg Medical Center, and is a graduate of University Of Missouri, Kansas City, School Of Medicine (1986).

NPPES Registry Identity

NPI1225030208
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameTODD D GWINCredential: MD
Location Address1520 BOILING SPRINGS RDBoiling Springs, SC 29316
Mailing Address1520 Boiling Springs RdBoiling Springs, SC 29316 · (864) 583-6381 · Fax (864) 583-5337
Fax(864) 583-5337
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Kansas City, School Of MedicineGraduated 1986
Enumeration DateAugust 10, 2005
Last NPPES UpdateAugust 22, 2023
NPI 1225030208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in SC · 14232
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
1520 BOILING SPRINGS RD, Boiling Springs, SC 29316

Other Identifiers 4

MedicaidGP1313SC
Other180018827Railroad Medicare
Other1050550001Dmerc
Medicaid14321SC

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

Todd D Gwin 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 ID1456342765
PECOS Enrollment IDI20040524000852
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 15

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 complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
1,323 services1,277 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.
384 services242 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.
240 services219 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
208 services156 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
193 services133 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
189 services185 patients

Hospital Affiliations CMS Care Compare

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

Spartanburg Medical Center

Acute Care Hospitals · Spartanburg, SC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number420007
Location101 E Wood StSpartanburg, SC 29303 · Spartanburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29316 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
$124.04 typical visit price
range $53.57 – $163.84
Typical copayment $31.01 (range $13.39 – $40.96)
Most-billed visit code 99204
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
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.

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.

97.79/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost92.65

Reported Quality Measures

Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance…
94%225 patients
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%827 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
95%22 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
98%6,435 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
85%810 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
5%44 patients1/55-star benchmark: 98%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%1,818 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
97%1,376 patients4/55-star benchmark: 100%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
95%168 patients5/55-star benchmark: 88%
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 screenedForUse: 98% · 986 patients
Patients tobacco: 98% · 62 patients
98%986 patients5/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%1,376 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%1,376 patients1/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 2,706 patients
0%2,706 patients5/55-star benchmark: 100%
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 6

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

Ophthalmology
1520 BOILING SPRINGS RD
BOILING SPRINGS, SC 29316
Ophthalmology
1520 BOILING SPRINGS RD
BOILING SPRINGS, SC 29316
Ophthalmology
1520 BOILING SPRINGS RD
BOILING SPRINGS, SC 29316
Ophthalmology
1520 BOILING SPRINGS RD
BOILING SPRINGS, SC 29316
Ophthalmology
1520 BOILING SPRINGS RD
BOILING SPRINGS, SC 29316
Ophthalmology
1520 BOILING SPRINGS RD
BOILING SPRINGS, SC 29316

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 Gwin's NPI number?

The NPI number for Todd Gwin is 1225030208. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Where is Todd Gwin located?

Todd Gwin practices at 1520 Boiling Springs Rd, Boiling Springs, SC 29316. The listed phone number is (864) 583-6381.

What is Todd Gwin's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Todd Gwin enrolled in Medicare?

Yes. Todd Gwin 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 Gwin accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, InStil Health and Molina Healthcare and 1 other insurer list Todd Gwin 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 Gwin affiliated with any hospitals?

According to CMS data, Todd Gwin is affiliated with Spartanburg Medical Center.

When was this NPI record last updated?

The NPPES record for Todd Gwin was last updated on August 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.