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JUSTIN MARC TOLMAN OD
NPI 1396790689
Optometrist in Yuba City, CA

Active since May 24, 2006PECOS EnrolledAccepts Medicare Assignment
1245 THARP RD, YUBA CITY, CA 95993(530) 674-5273(530) 674-5275 Get Directions Write a Review

NPPES record last updated: November 12, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Justin Marc Tolman Od NPPES

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

JUSTIN MARC TOLMAN OD (NPI 1396790689) is an individual optometrist in Yuba City, California, licensed in California (12712T) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Pacific University - College Of Optometry (2004).

NPPES Registry Identity

NPI1396790689
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameJUSTIN MARC TOLMANCredential: OD
Location Address1245 THARP RDYuba City, CA 95993
Mailing Address200 W Rio Bonito RdBiggs, CA 95917 · (530) 868-5065
Phone(530) 674-5273
Fax(530) 674-5275
Sole ProprietorNo
Medical School CMSPacific University - College Of OptometryGraduated 2004
Enumeration DateMay 24, 2006
Last NPPES UpdateNovember 12, 2009
✔ NPI 1396790689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in CA · 12712T
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
1245 THARP RD, Yuba City, CA 95993
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Other Identifiers 4

Medicare PINSD0127120CA
Medicare UPINV04006
Medicare PINZZZ23333ZCA
MedicaidSD0127120CA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas 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

Justin Marc Tolman Od 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 ID2062466642
PECOS Enrollment IDI20050307000391
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 10

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.

Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
522 services521 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.
168 services162 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.
98 services93 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
71 services71 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
55 services33 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
48 services45 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95993 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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

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
97%66 patients4/55-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 4

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

EMPOWERED MINDS
Psychologist (Intellectual and Developmental Disabilities)
1245 THARP RD
YUBA CITY, CA 95993
Sutter County (530) 844-3936
GARY RICHARD TAXERA OD
Optometrist
1245 THARP RD
YUBA CITY, CA 95993
Sutter County (530) 674-5273
ERIN ALIG-DIMALANTA LMFT
Counselor (Mental Health)
1245 THARP RD
YUBA CITY, CA 95993
Sutter County (530) 788-2766
THREE RIVERS OPTOMETRIC GROUP INC
Optometrist
1245 THARP RD
YUBA CITY, CA 95993
Sutter County (530) 674-5273

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 Justin Tolman's NPI number?

The NPI number for Justin Tolman is 1396790689. It was assigned to this individual provider in the NPPES registry on May 24, 2006.

Where is Justin Tolman located?

Justin Tolman practices at 1245 Tharp Rd, Yuba City, CA 95993. The listed phone number is (530) 674-5273.

What is Justin Tolman's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Justin Tolman enrolled in Medicare?

Yes. Justin Tolman 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 Justin Tolman accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Providence Health Plan list Justin Tolman 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 Justin Tolman was last updated on November 12, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.