DR. ETHAN WADE TOLBERT M.D.
NPI 1255537239
Internal Medicine - Hematology & Oncology in Atlanta, GA

Q: What is Ethan Tolbert's NPI number?

The NPI number for Ethan Tolbert is 1255537239. It was assigned to this individual provider in the NPPES registry on June 26, 2007.

Q: What is Ethan Tolbert's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Tolbert was last updated on August 18, 2020. 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 June 26, 2007PECOS EnrolledAccepts Medicare Assignment

68.38/100

CMS Quality Rating

550 PEACHTREE ST NE, SUITE 1185, ATLANTA, GA 30308(404) 223-0792(404) 223-5815 Get Directions Write a Review

NPPES record last updated: August 18, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 18, 2020, May 5, 2020 (2 updates tracked since 2020).

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About Dr. Ethan Wade Tolbert M.d. NPPES

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

DR. ETHAN WADE TOLBERT M.D. (NPI 1255537239) is an individual hematology & oncology provider in Atlanta, Georgia, licensed in Georgia (46265) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with Emory University Hospital, and is a graduate of University Of Tennessee, Hsc, College Of Medicine (1997).

NPPES Registry Identity

NPI1255537239

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameDR. ETHAN WADE TOLBERTCredential: M.D.

Location Address550 PEACHTREE ST NE, SUITE 1185Atlanta, GA 30308-2247

Mailing Address1835 Savoy Dr, Suite 300Atlanta, GA 30341-1072 · (404) 223-0792 · Fax (404) 223-5815

Phone(404) 223-0792

Fax(404) 223-5815

Sole ProprietorNo

Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 1997

Enumeration DateJune 26, 2007

Last NPPES UpdateAugust 18, 20202 updates tracked since enumeration

NPPES CertifiedAugust 18, 2020

✔ NPI 1255537239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in GA · 46265

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

550 PEACHTREE ST NE, Atlanta, GA 30308

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Other Identifiers 1

Medicaid463493784DGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.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. Ethan Wade Tolbert 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 ID4284797465

PECOS Enrollment IDI20090114000413

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 5

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.

200 services119 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.

140 services92 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

22 services22 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

16 services14 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Emory University Hospital

Acute Care Hospitals · Atlanta, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110010

Location1364 Clifton Road, NEAtlanta, GA 30322 · De Kalb County

Emergency services

Emory Decatur Hospital

Acute Care Hospitals · Decatur, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110076

Location2701 N Decatur RoadDecatur, GA 30033 · De Kalb County

Emergency services Birthing friendly

Emory University Hospital Midtown

Acute Care Hospitals · Atlanta, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110078

Location550 Peachtree Street, NEAtlanta, GA 30308 · Fulton County

Emergency services Birthing friendly

Saint Joseph's Hospital Of Atlanta, Inc

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110082

Location5665 Peachtree Dunwoody RoadAtlanta, GA 30342 · Fulton County

Emergency services

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30308 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

$172.43 typical visit price

range $56.84 – $172.43

Typical copayment $43.10 (range $14.21 – $43.10)

Most-billed visit code 99205

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

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.

68.38/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

70.82

Improvement Activities

Cost

40.24

Other Providers at the Same Location NPPES 20

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

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