TOBY GROPEN MD
NPI 1396707832
Psychiatry & Neurology - Neurology in Birmingham, AL

Active since April 03, 2006PECOS EnrolledAccepts Medicare Assignment
619 19TH ST S, BIRMINGHAM, AL 35249(205) 934-4011 Get Directions Write a Review

NPPES record last updated: June 29, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Toby Gropen Md NPPES

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

TOBY GROPEN MD (NPI 1396707832) is an individual neurology provider in Birmingham, Alabama, licensed in Alabama (34032) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Texas Medical School At San Antonio (1987).

NPPES Registry Identity

NPI1396707832
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameTOBY GROPENCredential: MD
Location Address619 19TH ST SBirmingham, AL 35249
Mailing AddressPo Box 55310Birmingham, AL 35255-5310
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 1987
Enumeration DateApril 3, 2006
Last NPPES UpdateJune 29, 2023
NPI 1396707832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License Licensed in AL · 34032
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
619 19TH ST S, Birmingham, AL 35249

Other Identifiers 2

Medicaid2179268LA
Medicaid07937808MS

Accepted 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

Toby Gropen 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 ID2567456718
PECOS Enrollment IDI20150706000684
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 7

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.

Ultrasound of both sides of head and neck blood flow 93880
An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.
44 services44 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
38 services19 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
24 services16 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.
20 services19 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
20 services11 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35249 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

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.

Radiology (Diagnostic Radiology)
619 19TH ST S, JT N342
BIRMINGHAM, AL 35249
Internal Medicine (Nephrology)
619 19TH ST S
BIRMINGHAM, AL 35249
Anesthesiology
619 19TH ST S
BIRMINGHAM, AL 35249
Surgery (Surgical Critical Care)
619 19TH ST S
BIRMINGHAM, AL 35249
Nurse Practitioner (Acute Care)
619 19TH ST S
BIRMINGHAM, AL 35249
Pharmacist
619 19TH ST S
BIRMINGHAM, AL 35249
Pathology (Anatomic Pathology & Clinical Pathology)
619 19TH ST S
BIRMINGHAM, AL 35249
Emergency Medicine
619 19TH ST S
BIRMINGHAM, AL 35249

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 Toby Gropen's NPI number?

The NPI number for Toby Gropen is 1396707832. It was assigned to this individual provider in the NPPES registry on April 3, 2006.

Where is Toby Gropen located?

Toby Gropen practices at 619 19th St S, Birmingham, AL 35249. The listed phone number is (205) 934-4011.

What is Toby Gropen's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Toby Gropen enrolled in Medicare?

Yes. Toby Gropen 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 Toby Gropen accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer list Toby Gropen 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 Toby Gropen was last updated on June 29, 2023. 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.