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MARIE ROSY TOUSSAINT M.D.
NPI 1326090689
Internal Medicine in Sebring, FL

Active since May 16, 2006PECOS EnrolledAccepts Medicare Assignment
119 US HIGHWAY 27 N, SEBRING, FL 33870(863) 382-0009(863) 314-0008 Get Directions Write a Review

NPPES record last updated: November 30, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 30, 2022, Sep 24, 2019, Oct 17, 2016 (3 updates tracked since 2016).

About Marie Rosy Toussaint M.d. NPPES

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

MARIE ROSY TOUSSAINT M.D. (NPI 1326090689) is an individual internal medicine provider in Sebring, Florida, licensed in Florida (ME57175) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Hca Florida Highlands Hospital, and is a graduate of Other (1981).

NPPES Registry Identity

NPI1326090689
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameMARIE ROSY TOUSSAINTCredential: M.D.
Location Address119 US HIGHWAY 27 NSebring, FL 33870-2100
Mailing Address119 Us Highway 27 NSebring, FL 33870-2100 · (633) 820-0009 · Fax (863) 314-0008
Phone(863) 382-0009
Fax(863) 314-0008
Sole ProprietorYes
Medical School CMSOtherGraduated 1981
Enumeration DateMay 16, 2006
Last NPPES UpdateNovember 30, 20223 updates tracked since enumeration
NPPES CertifiedNovember 30, 2022
✔ NPI 1326090689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME57175
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPreventive Medicine · Undersea and Hyperbaric MedicineTaxonomy 2083P0011X · License ME57175 (FL)
119 US HIGHWAY 27 N, Sebring, FL 33870
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Other Identifiers 3

OtherP00357887FL · Railroad Medicare
Other10205FL · Bcbs Florida
Medicaid374824300FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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

Marie Rosy Toussaint 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 ID5092782177
PECOS Enrollment IDI20040916001072
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 9

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.
193 services66 patients
Removal of skin and tissue, 20.0 sq cm or less 11042
This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
161 services31 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.
90 services40 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.
70 services15 patients
Removal of bone, 20.0 sq cm or less 11044
The procedure involves the surgical removal of a section of bone, up to 20.0 square cm in size. This may be necessary due to various reasons such as injury, infection, or to treat a disease. The process aims to alleviate pain, enhance mobility, or prevent the spread of disease.
42 services11 patients
Removal of muscle and/or tissue, 20.0 sq cm or less 11043
This procedure involves the surgical removal of a specified area (20.0 sq cm or less) of muscle and/or tissue. It's typically done to treat conditions like tumors, infections, or injuries. Local or general anesthesia ensures comfort. Recovery time varies.
40 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Hca Florida Highlands Hospital

Acute Care Hospitals · Sebring, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100049
Location3600 S Highlands AveSebring, FL 33870 · Highlands County
Emergency services

Adventhealth Sebring

Acute Care Hospitals · Sebring, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100109
Location4200 Sun N Lake BlvdSebring, FL 33872 · Highlands County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33870 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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

Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
29%38 patients2/55-star benchmark: 98%
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.
81%616 patients3/55-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.
90%2,339 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
91%96 patients5/55-star benchmark: 90%
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…
12%200 patients1/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
20%51 patients1/55-star benchmark: 88%
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
45%154 patients2/55-star benchmark: 96%
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…
10%200 patients1/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 9% · 96 patients
20%96 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.

Referred Medical Equipment & Supplies CMS DME claims 9

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers15 claims15 services$38.28 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers25 claims25 services$90.57 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
3 suppliers26 claims66 services$34.78 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
3 suppliers16 claims16 services$18.62 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
3 suppliers29 claims125 services$2.24 avg. paid by Medicare
Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046
DME-Other DME · category DE001N
3 suppliers11 claims11 services$12.55 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

DEEPAK T PATEL MD
Internal Medicine (Pulmonary Disease)
119 US HIGHWAY 27 N
SEBRING, FL 33870
Highlands County (863) 382-0009

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 Marie Toussaint's NPI number?

The NPI number for Marie Toussaint is 1326090689. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is Marie Toussaint located?

Marie Toussaint practices at 119 Us Highway 27 N, Sebring, FL 33870. The listed phone number is (863) 382-0009.

What is Marie Toussaint's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Marie Toussaint enrolled in Medicare?

Yes. Marie 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 Marie Toussaint accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Marie 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.

Is Marie Toussaint affiliated with any hospitals?

According to CMS data, Marie Toussaint is affiliated with Hca Florida Highlands Hospital and Adventhealth Sebring.

When was this NPI record last updated?

The NPPES record for Marie Toussaint was last updated on November 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.