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

Q: 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.

Q: What is Toby Paulson's specialty?

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

Q: 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.

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: October 18, 2026.

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

On this page

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

Phone(801) 492-2815

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

Open in Google Maps ↗

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

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Imperial Health Plan of the Southwest, Inc., Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

Medicare enrollment records show Toby Paulson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ihc Health Services Inc

Same address

Family Medicine

10968 N ALPINE HWY
Highland, UT 84003

Reassigned Medicare billing, Utah enrollment
1,729 clinicians in this Medicare group

NPI 1083742589 (801) 763-2900

Revere Health PC

7.0 mi

Multi-Specialty

1055 N 500 W
Provo, UT 84604

Reassigned Medicare billing, Utah enrollment
414 clinicians in this Medicare group

NPI 1093764805 (801) 429-8000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

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

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

82 services81 patients

Technetium tc-99m sestamibi, diagnostic, per study dose A9500

Technetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.

78 services39 patients

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.

56 services46 patients

Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries A9555

Rubidium Rb-82 is a radioactive drug used in a PET scan to help visualize the heart. It helps detect areas with poor blood flow, aiding in diagnosing heart conditions. The dose is up to 60 millicuries per study.

52 services26 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

46 services46 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

44 services44 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

41 services36 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

40 services40 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

39 services30 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

31 services31 patients

Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan 78431

This is a diagnostic test where a tiny amount of radioactive material is used to examine your heart's blood flow at rest & during stress, alongside a CT scan for detailed images. It helps identify any heart-related issues like blockages or damage.

30 services30 patients

Nuclear medicine study of heart muscle blood flow by pet 78434

A nuclear medicine study of heart muscle blood flow by PET is a non-invasive test that uses a small amount of radioactive substance to create detailed images of your heart's blood flow and function. It helps assess heart health and diagnose heart conditions.

30 services30 patients

Injection, perflutren lipid microspheres, per ml Q9957

Perflutren lipid microspheres injection, per ml, is a diagnostic tool used to enhance ultrasound images. It contains tiny gas-filled bubbles that improve the clarity of the images, aiding in a more accurate diagnosis.

29 services14 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional 93228

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

28 services28 patients

Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan 78431

26 services26 patients

Nuclear medicine study of heart muscle blood flow by pet 78434

26 services26 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

24 services24 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

20 services18 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

19 services18 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

17 services16 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.

16 services13 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

16 services15 patients

Insertion of tube in coronary artery for diagnosis with review by radiologist 93454

This procedure involves placing a small tube into your coronary artery. It helps to identify any blockages or issues within the artery. A radiologist, a doctor specialized in medical imaging, will review the results to ensure accurate diagnosis.

16 services16 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

15 services15 patients

Electrocardiogram (ecg) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional 93229

An Electrocardiogram (ECG) is a test that records your heart's electrical activity for up to 30 days. You trigger a transmission if you feel symptoms, which is then reviewed by a healthcare professional. The report helps diagnose heart conditions.

15 services15 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.

MS. YUN LING MD

Internal Medicine

1175 E 50 S, SUITE 241
AMERICAN FORK, UT 84003

Utah County (801) 492-5999

CENTRAL UTAH CLINIC, P.C.

Clinic/Center (Multi-Specialty)

1175 E 50 S
AMERICAN FORK, UT 84003

Utah County (801) 429-8000

SCOTT K SUMMERS FNP

Nurse Practitioner (Family)

1175 E 50 S, SUITE 211
AMERICAN FORK, UT 84003

Utah County (801) 418-0870

TIMPVIEW ASC, LLC

Clinic/Center (Ambulatory Surgical)

1175 E 50 S
AMERICAN FORK, UT 84003

Utah County (719) 492-5994

SHELLIE MARIE NORTON AU.D

Audiologist

1175 E 50 S, 211
AMERICAN FORK, UT 84003

Utah County (801) 418-0874

CENTRAL UTAH CLINIC, P.C.

Clinic/Center (Ambulatory Surgical)

1175 E 50 S, SUITE 101
AMERICAN FORK, UT 84003

Utah County (801) 492-5994

DR. CASEY RAY OWENS M.D.

Internal Medicine (Gastroenterology)

1175 E 50 S, STE 221
AMERICAN FORK, UT 84003

Utah County (801) 772-0775

DR. JASON MARK HUDDLESTON DO

Internal Medicine

1175 E 50 S, SUITE 241
AMERICAN FORK, UT 84003

Utah County (801) 492-5999

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.

Which organizations bill Medicare for Toby Paulson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Toby Paulson reassigns Medicare benefits to 2 organizations: Ihc Health Services Inc (Highland, UT) and Revere Health PC (Provo, UT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Toby Paulson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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.