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DR. RICHARD LEE TOLER D.O.
NPI 1295936722
Obstetrics & Gynecology in Bolivia, NC

Active since May 31, 2007PECOS EnrolledAccepts Medicare Assignment
584 HOSPITAL DR, SUITE B, BOLIVIA, NC 28422(910) 721-4050(910) 721-4051 Get Directions Write a Review

NPPES record last updated: July 17, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Richard Lee Toler D.o. NPPES

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

DR. RICHARD LEE TOLER D.O. (NPI 1295936722) is an individual obstetrics & gynecology provider in Bolivia, North Carolina, licensed in North Carolina (2009-1673) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Grand Strand Regional Medical Center, and maintains a secondary practice location in Myrtle Beach.

NPPES Registry Identity

NPI1295936722
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameDR. RICHARD LEE TOLERCredential: D.O.
Location Address584 HOSPITAL DR, SUITE BBolivia, NC 28422
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-7840 · Fax (704) 384-7830
Phone(910) 721-4050
Fax(910) 721-4051
Sole ProprietorNo
Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 2006
Enumeration DateMay 31, 2007
Last NPPES UpdateJuly 17, 2025
NPPES CertifiedJuly 17, 2025
✔ NPI 1295936722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses✔ Licensed in NC · 2009-1673✔ Licensed in SC · 91390
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
584 HOSPITAL DR, Bolivia, NC 28422
Open in Google Maps ↗

Secondary Practice Location 1

Location 1809 82nd PkwyMyrtle Beach, SC 29572-4607 · Phone (800) 967-2289

Other Identifiers 2

Medicaid5916542NC
MedicaidNC4976SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina 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

Dr. Richard Lee Toler 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 ID9335336049
PECOS Enrollment IDI20240715003974
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

2

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

Coastal Carolina Primary Care, LLC
35 mi
Endocrinology, Diabetes & Metabolism
920 DOUG WHITE DR STE 250
Myrtle Beach, SC 29572
  • Reassigned Medicare billing, South Carolina enrollment
  • 33 clinicians in this Medicare group
NPI 1821257676 (843) 236-1950
Obhg South Carolina PC
241 mi
Obstetrics & Gynecology
777 LOWNDES HILL RD BLDG 1
Greenville, SC 29607
  • Reassigned Medicare billing, South Carolina enrollment
  • 190 clinicians in this Medicare group
NPI 1538457361 (800) 967-2289

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 3

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 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.
39 services27 patients
Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
17 services17 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.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

Grand Strand Regional Medical Center

Acute Care Hospitals · Myrtle Beach, SC
3/5 CMS rating
OwnershipProprietary
CMS Certification Number420085
Location809 82nd ParkwayMyrtle Beach, SC 29572 · Horry County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28422 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
77%30 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
46%28 patients2/55-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…
33%102 patients2/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
68%28 patients3/55-star benchmark: 98%
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 3

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

DR. EMILY GRACE LINEBERGER CNM, WHNP
Advanced Practice Midwife
584 HOSPITAL DR, SUITE B
BOLIVIA, NC 28422
Brunswick County (630) 740-6161
TRACEY NICOLE MCCARTHY DO
Obstetrics & Gynecology
584 HOSPITAL DR, SUITE B
BOLIVIA, NC 28422
Brunswick County (910) 721-4050
EDWARD WOO MD
Obstetrics & Gynecology
584 HOSPITAL DR, SUITE B
BOLIVIA, NC 28422
Brunswick County (910) 721-4050

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 Richard Toler's NPI number?

The NPI number for Richard Toler is 1295936722. It was assigned to this individual provider in the NPPES registry on May 31, 2007.

Where is Richard Toler located?

Richard Toler practices at 584 Hospital Dr Suite B, Bolivia, NC 28422. The listed phone number is (910) 721-4050.

What is Richard Toler's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Richard Toler enrolled in Medicare?

Yes. Richard Toler 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 Richard Toler's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Richard Toler reassigns Medicare benefits to 2 organizations: Coastal Carolina Primary Care, LLC (Myrtle Beach, SC) and Obhg South Carolina PC (Greenville, SC). 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 Richard Toler's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Richard Toler accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and Molina Healthcare list Richard Toler 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 Richard Toler affiliated with any hospitals?

According to CMS data, Richard Toler is affiliated with Grand Strand Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Richard Toler was last updated on July 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.