VISHAL TOLIA DO
NPI 1316366297
Internal Medicine - Pulmonary Disease in Northport, NY

Active since April 08, 2014PECOS EnrolledAccepts Medicare Assignment
91.25/100
CMS Quality Rating
79 MIDDLEVILLE RD, NORTHPORT, NY 11768(631) 261-4400 Get Directions Write a Review

NPPES record last updated: April 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 8, 2025, Apr 7, 2022 (2 updates tracked since 2022).

About Vishal Tolia Do NPPES

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

VISHAL TOLIA DO (NPI 1316366297) is an individual pulmonary disease provider in Northport, New York, licensed in New York (289370) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2014).

NPPES Registry Identity

NPI1316366297
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameVISHAL TOLIACredential: DO
Location Address79 MIDDLEVILLE RDNorthport, NY 11768-2200
Mailing Address79 Middleville RdNorthport, NY 11768-2200 · (631) 261-4400
Sole ProprietorNo
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2014
Enumeration DateApril 8, 2014
Last NPPES UpdateApril 28, 20252 updates tracked since enumeration
NPPES CertifiedApril 28, 2025
NPI 1316366297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
Licenses Licensed in NY · 289370 Licensed in NM · DO2024-0155
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 289370 (NY)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 289370 (NY)
79 MIDDLEVILLE RD, Northport, NY 11768

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

Vishal Tolia Do 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 ID4880936921
PECOS Enrollment IDI20260206002347
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11768 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
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

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.

Social Worker
79 MIDDLEVILLE RD
NORTHPORT, NY 11768
Social Worker (Clinical)
79 MIDDLEVILLE RD
NORTHPORT, NY 11768
Anesthesiology
79 MIDDLEVILLE RD
NORTHPORT, NY 11768
General Acute Care Hospital
79 MIDDLEVILLE RD
NORTHPORT, NY 11768
Social Worker
79 MIDDLEVILLE RD
NORTHPORT, NY 11768
Nurse Practitioner (Psychiatric/Mental Health)
79 MIDDLEVILLE RD
NORTHPORT, NY 11768
Pharmacist
79 MIDDLEVILLE RD
NORTHPORT, NY 11768
Occupational Therapist
79 MIDDLEVILLE RD
NORTHPORT, NY 11768

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 Vishal Tolia's NPI number?

The NPI number for Vishal Tolia is 1316366297. It was assigned to this individual provider in the NPPES registry on April 8, 2014.

Where is Vishal Tolia located?

Vishal Tolia practices at 79 Middleville Rd, Northport, NY 11768. The listed phone number is (631) 261-4400.

What is Vishal Tolia's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Vishal Tolia enrolled in Medicare?

Yes. Vishal Tolia 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.

When was this NPI record last updated?

The NPPES record for Vishal Tolia was last updated on April 28, 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.