ROBERT J TOLTZIS M.D.
NPI 1265480677
Internal Medicine - Cardiovascular Disease in Newport, KY

Active since May 05, 2006PECOS EnrolledAccepts Medicare Assignment
90.38/100
CMS Quality Rating
1400 GRAND AVE, NEWPORT, KY 41071(859) 905-3073(859) 441-1460 Get Directions Write a Review

NPPES record last updated: November 8, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 8, 2021, Feb 26, 2021, Sep 4, 2018 and 1 more (4 updates tracked since 2018).

About Robert J Toltzis M.d. NPPES

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

ROBERT J TOLTZIS M.D. (NPI 1265480677) is an individual cardiovascular disease provider in Newport, Kentucky, licensed in Kentucky (42449) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Ft Thomas, and is a graduate of Hahnemann University College Of Medicine (1974).

NPPES Registry Identity

NPI1265480677
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameROBERT J TOLTZISCredential: M.D.
Location Address1400 GRAND AVENewport, KY 41071-2570
Mailing AddressPo Box 635283Cincinnati, OH 45263-5283 · (859) 905-3073 · Fax (859) 441-1460
Fax(859) 441-1460
Sole ProprietorNo
Medical School CMSHahnemann University College Of MedicineGraduated 1974
Enumeration DateMay 5, 2006
Last NPPES UpdateNovember 8, 20214 updates tracked since enumeration
NPPES CertifiedNovember 8, 2021
NPI 1265480677 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Licenses Licensed in KY · 42449 Licensed in IN · 01037357A
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.
1400 GRAND AVE, Newport, KY 41071

Other Identifiers 5

Medicaid100387000IN
OtherP00340834OH · Rail Road Medicare
Medicaid0507580OH
Medicaid64781883KY
OtherP00948069KY · Rr Medicare

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

Robert J Toltzis 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 ID9335173491
PECOS Enrollment IDI20060530000008
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 16

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.

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.
550 services465 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.
366 services303 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.
207 services206 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.
168 services167 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.
111 services63 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
62 services62 patients

Hospital Affiliations CMS Care Compare 3

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

St Elizabeth Ft Thomas

Acute Care Hospitals · Fort Thomas, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180001
Location85 North Grand AvenueFort Thomas, KY 41075 · Campbell County
Emergency services

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180035
Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County
Emergency services Birthing friendly

St Elizabeth Florence

Acute Care Hospitals · Florence, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180045
Location4900 Houston RoadFlorence, KY 41042 · Boone County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41071 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
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.

90.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.76
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
62%184 patients3/55-star benchmark: 100%
Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
Patients 65+: 96% · 48 patients
96%53 patients
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
75%344 patients4/55-star benchmark: 100%
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…
21%410 patients1/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
0%341 patients1/55-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 20

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

Internal Medicine
1400 GRAND AVE
NEWPORT, KY 41071
Family Medicine
1400 GRAND AVE
NEWPORT, KY 41071
Internal Medicine
1400 GRAND AVE
NEWPORT, KY 41071
Urology
1400 GRAND AVE
NEWPORT, KY 41071
Nurse Practitioner
1400 GRAND AVE
NEWPORT, KY 41071
Ophthalmology
1400 GRAND AVE
NEWPORT, KY 41071
Urology
1400 GRAND AVE
NEWPORT, KY 41071
Obstetrics & Gynecology (Gynecology)
1400 GRAND AVE
NEWPORT, KY 41071

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 Robert Toltzis's NPI number?

The NPI number for Robert Toltzis is 1265480677. It was assigned to this individual provider in the NPPES registry on May 5, 2006.

Where is Robert Toltzis located?

Robert Toltzis practices at 1400 Grand Ave, Newport, KY 41071. The listed phone number is (859) 905-3073.

What is Robert Toltzis's specialty?

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

Is Robert Toltzis enrolled in Medicare?

Yes. Robert Toltzis 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 Robert Toltzis accept?

Health plans from Blue Cross Blue Shield of Wyoming and Sanford Health Plan list Robert Toltzis 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 Robert Toltzis affiliated with any hospitals?

According to CMS data, Robert Toltzis is affiliated with St Elizabeth Ft Thomas, St Elizabeth Edgewood and St Elizabeth Florence.

When was this NPI record last updated?

The NPPES record for Robert Toltzis was last updated on November 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.