TOBY PAULSON D.O.
NPI 1235264169
Internal Medicine - Cardiovascular Disease in American Fork, UT

Active since February 22, 2007PECOS EnrolledAccepts Medicare Assignment
1175 E 50 S, STE 251, AMERICAN FORK, UT 84003(801) 492-2815(801) 492-0191 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2020, Dec 4, 2017, Aug 18, 2016 (3 updates tracked since 2016).

About Toby Paulson D.o. NPPES

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

TOBY PAULSON D.O. (NPI 1235264169) is an individual cardiovascular disease provider in American Fork, Utah, licensed in Utah (8281654-1204) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS, is affiliated with Utah Valley Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1235264169
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameTOBY PAULSONCredential: D.O.
Location Address1175 E 50 S, STE 251American Fork, UT 84003-2845
Mailing Address1055 N 500 W, Attn: CredentialingProvo, UT 84604-3305 · (801) 354-8225 · Fax (801) 418-0941
Fax(801) 492-0191
Sole ProprietorYes
Medical School CMSOhio University, College Of Osteopathic MedicineGraduated 2005
Enumeration DateFebruary 22, 2007
Last NPPES UpdateNovember 27, 20233 updates tracked since enumeration
NPPES CertifiedMarch 17, 2020
NPI 1235264169 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License Licensed in UT · 8281654-1204
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedInternal MedicineTaxonomy 207R00000X · License 8938 (OH)
Also ListedHospitalistTaxonomy 208M00000X · License 20A12193 (CA)
1175 E 50 S, American Fork, UT 84003

Secondary Practice Locations 2

Location 13000 N Triumph Blvd Ste 100Lehi, UT 84043-4999 · Phone (801) 373-4366
Location 2700 W 800 N Ste 230Orem, UT 84057-6301 · Phone (801) 429-0620

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 Paulson D.o. 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 ID7719081579
PECOS Enrollment IDI20160922001363
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 31

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.

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
249 services243 patients
Injection, regadenoson, 0.1 mg J2785
Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.
204 services51 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.
195 services143 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
189 services130 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
136 services129 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.
92 services89 patients

Hospital Affiliations CMS Care Compare 5

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

Utah Valley Hospital

Acute Care Hospitals · Provo, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460001
Location1034 North 500 WestProvo, UT 84604 · Utah County
Emergency services Birthing friendly

Castleview Hospital

Acute Care Hospitals · Price, UT
4/5 CMS rating
OwnershipProprietary
CMS Certification Number460011
Location300 North Hospital DrivePrice, UT 84501 · Carbon County
Emergency services Birthing friendly

American Fork Hospital

Acute Care Hospitals · American Fork, UT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460023
Location170 North 1100 EastAmerican Fork, UT 84003 · Utah County
Emergency services Birthing friendly

Holy Cross Hospital-Jordan Valley

Acute Care Hospitals · West Jordan, UT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460051
Location3580 West 9000 SouthWest Jordan, UT 84088 · Salt Lake County
Emergency services Birthing friendly

Timpanogos Regional Hospital

Acute Care Hospitals · Orem, UT
3/5 CMS rating
OwnershipProprietary
CMS Certification Number460052
Location750 West 800 NorthOrem, UT 84057 · Utah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84003 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
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers28 claims29 services$18.71 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
4 suppliers19 claims19 services$37.34 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
8 suppliers90 claims91 services$98.13 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$35.47 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 11

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

Internal Medicine
1175 E 50 S, SUITE 241
AMERICAN FORK, UT 84003
Clinic/Center (Multi-Specialty)
1175 E 50 S
AMERICAN FORK, UT 84003
Nurse Practitioner (Family)
1175 E 50 S, SUITE 211
AMERICAN FORK, UT 84003
Clinic/Center (Ambulatory Surgical)
1175 E 50 S
AMERICAN FORK, UT 84003
Audiologist
1175 E 50 S, 211
AMERICAN FORK, UT 84003
Clinic/Center (Ambulatory Surgical)
1175 E 50 S, SUITE 101
AMERICAN FORK, UT 84003
Internal Medicine (Gastroenterology)
1175 E 50 S, STE 221
AMERICAN FORK, UT 84003
Internal Medicine
1175 E 50 S, SUITE 241
AMERICAN FORK, UT 84003

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 Paulson's NPI number?

The NPI number for Toby Paulson is 1235264169. It was assigned to this individual provider in the NPPES registry on February 22, 2007.

Where is Toby Paulson located?

Toby Paulson practices at 1175 E 50 S Ste 251, American Fork, UT 84003. The listed phone number is (801) 492-2815.

What is Toby Paulson's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Toby Paulson enrolled in Medicare?

Yes. Toby Paulson 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 Paulson accept?

Health plans from BridgeSpan Health Company, Imperial Health Plan of the Southwest, Inc., Molina Healthcare, Regence BlueCross BlueShield of Utah and Select Health and 1 other insurer list Toby Paulson 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 Paulson affiliated with any hospitals?

According to CMS data, Toby Paulson is affiliated with Utah Valley Hospital, Castleview Hospital, American Fork Hospital, Holy Cross Hospital-Jordan Valley and Timpanogos Regional Hospital.

When was this NPI record last updated?

The NPPES record for Toby Paulson was last updated on November 27, 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.