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DR. TOBY L ANDERTON M.D.
NPI 1225359474
Orthopaedic Surgery in Twin Falls, ID

Active since June 22, 2010PECOS EnrolledAccepts Medicare Assignment
0/100
CMS Quality Rating
2167 VILLAGE PARK AVE, SUITE 200, TWIN FALLS, ID 83301(208) 735-3728(208) 735-3729 Get Directions Write a Review

NPPES record last updated: September 17, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Toby L Anderton M.d. NPPES

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

DR. TOBY L ANDERTON M.D. (NPI 1225359474) is an individual orthopaedic surgery provider in Twin Falls, Idaho, licensed in Idaho (M14513) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS, is affiliated with St Lukes Magic Valley Medical Center, and is a graduate of State University Of Ny Upstate Medical University (2010).

NPPES Registry Identity

NPI1225359474
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. TOBY L ANDERTONCredential: M.D.
Location Address2167 VILLAGE PARK AVE, SUITE 200Twin Falls, ID 83301
Mailing Address2167 Village Park Ave, Suite 200Twin Falls, ID 83301 · (208) 735-3728 · Fax (208) 735-3729
Phone(208) 735-3728
Fax(208) 735-3729
Sole ProprietorNo
Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 2010
Enumeration DateJune 22, 2010
Last NPPES UpdateSeptember 17, 2019
✔ NPI 1225359474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in ID · M14513
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
2167 VILLAGE PARK AVE, Twin Falls, ID 83301
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan, Select Health.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. Toby L Anderton M.d. 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 ID7719126077
PECOS Enrollment IDI20190321000558
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 11

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.
335 services177 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
114 services74 patients
X-ray of knee, 4 or more views 73564
An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
97 services40 patients
X-ray of hip, 2-3 views 73502
An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
90 services39 patients
X-ray of knee, 1-2 views 73560
An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.
75 services31 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
68 services12 patients

Hospital Affiliations CMS Care Compare 2

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

St Lukes Magic Valley Medical Center

Acute Care Hospitals · Twin Falls, ID
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130002
Location801 Pole Line Road WestTwin Falls, ID 83301 · Twin Falls County
Emergency services Birthing friendly

North Canyon Medical Center

Critical Access Hospitals · Gooding, ID
OwnershipVoluntary non-profit - Private
CMS Certification Number131302
Location267 North Canyon DrGooding, ID 83330 · Gooding County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83301 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
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
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.

0/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Promoting Interoperability0
Improvement Activities0

Reported Quality Measures

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.
99%3,142 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.
Patients 1: 50% · 2,360 patients
50%2,360 patients3/55-star benchmark: 100%
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.
99%3,162 patients4/55-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.
85%1,376 patients4/55-star benchmark: 99%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
99%1,119 patients5/55-star benchmark: 97%
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: 52% · 616 patients
Patients tobacco: 49% · 616 patients
64%55 patients3/55-star benchmark: 98%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
Patients 1: 60% · 1,376 patients
60%1,376 patients3/55-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 certified EHR technology to the patient (or the patient-authorized representative), or in…
0%1,376 patients1/55-star benchmark: 99%
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
Patients nutrition: 7% · 120 patients
Patients physicalActivity: 99% · 120 patients
100%120 patients
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.

Referred Medical Equipment & Supplies CMS DME claims 3

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

Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf L1851
DME-Orthotic Devices · category DF011N
1 supplier15 claims15 services$527.73 avg. paid by Medicare
Addition to lower extremity orthosis, suspension sleeve L2397
DME-Orthotic Devices · category DF000N
1 supplier11 claims11 services$103.16 avg. paid by Medicare
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf L3670
DME-Orthotic Devices · category DF000N
1 supplier11 claims11 services$89.87 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

DR. CRAIG J MANNING DC
Chiropractor
2167 VILLAGE PARK AVE, STE 100
TWIN FALLS, ID 83301
Twin Falls County (208) 737-1430

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 Anderton's NPI number?

The NPI number for Toby Anderton is 1225359474. It was assigned to this individual provider in the NPPES registry on June 22, 2010.

Where is Toby Anderton located?

Toby Anderton practices at 2167 Village Park Ave Suite 200, Twin Falls, ID 83301. The listed phone number is (208) 735-3728.

What is Toby Anderton's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Toby Anderton enrolled in Medicare?

Yes. Toby Anderton 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 Anderton accept?

Health plans from Providence Health Plan and Select Health list Toby Anderton 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 Anderton affiliated with any hospitals?

According to CMS data, Toby Anderton is affiliated with St Lukes Magic Valley Medical Center and North Canyon Medical Center.

When was this NPI record last updated?

The NPPES record for Toby Anderton was last updated on September 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.