TONYA A SEXTON-ANDERSON D.O.
NPI 1265538441
Family Medicine in Howell, MI

Q: What is Tonya Sexton-anderson's NPI number?

The NPI number for Tonya Sexton-anderson is 1265538441. It was assigned to this individual provider in the NPPES registry on September 15, 2006.

Q: What is Tonya Sexton-anderson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since September 15, 2006PECOS EnrolledAccepts Medicare Assignment

202 W HIGHLAND RD, HOWELL, MI 48843(517) 234-6540(517) 338-9083 Get Directions Write a Review

NPPES record last updated: November 19, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 19, 2024, Oct 7, 2019, Dec 12, 2017 (3 updates tracked since 2017).

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About Tonya A Sexton-anderson D.o. NPPES

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

TONYA A SEXTON-ANDERSON D.O. (NPI 1265538441) is an individual family medicine provider in Howell, Michigan, licensed in Michigan (5101012802) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Trinity Health Oakland Hospital, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1265538441

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameTONYA A SEXTON-ANDERSONCredential: D.O.

Location Address202 W HIGHLAND RDHowell, MI 48843-1162

Mailing Address24 Frank Lloyd Wright Dr Ste J2000Ann Arbor, MI 48105-9484 · (734) 747-6766

Phone(517) 234-6540

Fax(517) 338-9083

Sole ProprietorNo

Medical School CMSOtherGraduated 1995

Enumeration DateSeptember 15, 2006

Last NPPES UpdateNovember 19, 20243 updates tracked since enumeration

NPPES CertifiedNovember 19, 2024

✔ NPI 1265538441 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 5101012802

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

202 W HIGHLAND RD, Howell, MI 48843

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority 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

Tonya A Sexton-anderson 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 ID1951456458

PECOS Enrollment IDI20090904000548

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 10

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.

286 services148 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

97 services46 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

86 services86 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

84 services56 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.

42 services37 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

36 services36 patients

Hospital Affiliations CMS Care Compare 4

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

Trinity Health Oakland Hospital

Acute Care Hospitals · Pontiac, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230029

Location44405 Woodward AvePontiac, MI 48341 · Oakland County

Emergency services Birthing friendly

Saint Joseph Mercy Livingston Hospital

Acute Care Hospitals · Howell, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230069

Location620 Byron RdHowell, MI 48843 · Livingston County

Emergency services

Trinity Health Ann Arbor Hospital

Acute Care Hospitals · Ann Arbor, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230156

Location5301 E Huron River DrAnn Arbor, MI 48106 · Washtenaw County

Emergency services Birthing friendly

Chelsea Hospital

Acute Care Hospitals · Chelsea, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230259

Location775 S Main StChelsea, MI 48118 · Washtenaw County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48843 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

Reported Quality Measures

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.

96%6,137 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

63%963 patients3/55-star benchmark: 88%

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.

97%187 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.

88%1,477 patients4/55-star benchmark: 97%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

100%1,477 patients5/55-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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

27%1,477 patients2/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

32%1,477 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 2

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

8 suppliers23 claims50 services$6.06 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers13 claims16 services$1.08 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 7

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

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