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BRIAN WILLIAM TOUSSAINT MD
NPI 1295969616
Ophthalmology in Wilmington, DE

Active since May 13, 2009PECOS EnrolledAccepts Medicare Assignment
1700 WAWASET ST, SUITE 200, WILMINGTON, DE 19806(302) 655-1500(302) 655-4084 Get Directions Write a Review

NPPES record last updated: February 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Brian William Toussaint Md NPPES

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

BRIAN WILLIAM TOUSSAINT MD (NPI 1295969616) is an individual ophthalmology provider in Wilmington, Delaware, licensed in Delaware (C1-0011273) and active in the NPI registry since May 2009. He is enrolled in Medicare PECOS and is a graduate of Georgetown University School Of Medicine (2009).

NPPES Registry Identity

NPI1295969616
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameBRIAN WILLIAM TOUSSAINTCredential: MD
Location Address1700 WAWASET ST, SUITE 200Wilmington, DE 19806-2142
Mailing Address1700 Wawaset St, Suite 200Wilmington, DE 19806-2142 · (302) 655-1500 · Fax (302) 655-4084
Phone(302) 655-1500
Fax(302) 655-4084
Sole ProprietorNo
Medical School CMSGeorgetown University School Of MedicineGraduated 2009
Enumeration DateMay 13, 2009
Last NPPES UpdateFebruary 9, 2024
NPPES CertifiedFebruary 9, 2024
✔ NPI 1295969616 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in DE · C1-0011273
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedOphthalmology · Retina SpecialistTaxonomy 207WX0107X · License C1-0011273 (DE)
1700 WAWASET ST, Wilmington, DE 19806
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Other Identifiers 1

Medicaid250596048DE

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan 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

Brian William Toussaint Md 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 ID3678712320
PECOS Enrollment IDI20150908002248
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 13

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.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
20,220 services70 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
1,455 services553 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
985 services210 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.
840 services354 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.
466 services353 patients
Injection, bevacizumab, 10 mg J9035
Bevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.
349 services105 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19806 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
$131.15 typical visit price
range $57.12 – $173.08
Typical copayment $32.78 (range $14.28 – $43.27)
Most-billed visit code 99204
Established Patient
$71.19 typical visit price
range $18.36 – $141.05
Typical copayment $17.79 (range $4.59 – $35.26)
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

Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…
100%170 patients5/55-star benchmark: 100%
Age-Related Macular Degeneration (AMD): Dilated Macular Examination
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…
100%170 patients5/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%292 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
91%211 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
6%3,185 patients1/55-star benchmark: 100%
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.
100%200 patients5/55-star benchmark: 100%
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.
17%354 patients1/55-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.
61%974 patients3/55-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
58%569 patients3/55-star benchmark: 95%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
6%34 patients1/55-star benchmark: 100%
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…
61%974 patients3/55-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 3

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

CHARLES WANG, MD, PA
Ophthalmology
1700 WAWASET ST, SUITE 200
WILMINGTON, DE 19806
New Castle County (302) 655-1500
CHARLES WANG MD
Ophthalmology
1700 WAWASET ST, STE 200
WILMINGTON, DE 19806
New Castle County (302) 655-1500
DR. WILLIAM ROGER ATKINS JR. M.D.
Physical Medicine & Rehabilitation (Pain Medicine)
1700 WAWASET ST, SUITE 100
WILMINGTON, DE 19806
New Castle County (302) 777-3955

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 Brian Toussaint's NPI number?

The NPI number for Brian Toussaint is 1295969616. It was assigned to this individual provider in the NPPES registry on May 13, 2009.

Where is Brian Toussaint located?

Brian Toussaint practices at 1700 Wawaset St Suite 200, Wilmington, DE 19806. The listed phone number is (302) 655-1500.

What is Brian Toussaint's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Brian Toussaint enrolled in Medicare?

Yes. Brian Toussaint 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 Brian Toussaint accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 2 other insurers list Brian Toussaint 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.

When was this NPI record last updated?

The NPPES record for Brian Toussaint was last updated on February 9, 2024. 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.