TONI O PACIOLES MD
NPI 1396959995
Internal Medicine - Hematology & Oncology in Huntington, WV

Q: What is Toni Pacioles's NPI number?

The NPI number for Toni Pacioles is 1396959995. It was assigned to this individual provider in the NPPES registry on May 10, 2007.

Q: What is Toni Pacioles's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Toni Pacioles was last updated on December 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 10, 2007PECOS EnrolledAccepts Medicare Assignment

29.83/100

CMS Quality Rating

1400 HAL GREER BLVD, HUNTINGTON, WV 25701(304) 399-6610(304) 399-6667 Get Directions Write a Review

NPPES record last updated: December 6, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 6, 2021, May 11, 2021, May 3, 2021 (3 updates tracked since 2021).

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About Toni O Pacioles Md NPPES

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

TONI O PACIOLES MD (NPI 1396959995) is an individual hematology & oncology provider in Huntington, West Virginia, licensed in West Virginia (25509) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with King's Daughters' Medical Center, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1396959995

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameTONI O PACIOLESCredential: MD

Location Address1400 HAL GREER BLVDHuntington, WV 25701-4114

Mailing Address1400 Hal Greer BlvdHuntington, WV 25701-4114 · (304) 399-6610 · Fax (304) 399-6621

Phone(304) 399-6610

Fax(304) 399-6667

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateMay 10, 2007

Last NPPES UpdateDecember 6, 20213 updates tracked since enumeration

NPPES CertifiedDecember 6, 2021

✔ NPI 1396959995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in WV · 25509

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Also ListedInternal MedicineTaxonomy 207R00000X · License 25509 (WV)

1400 HAL GREER BLVD, Huntington, WV 25701

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.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

Toni O Pacioles 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 ID5092942185

PECOS Enrollment IDI20131217000954

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.

834 services321 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

323 services104 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.

139 services101 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

85 services85 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.

59 services54 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.

56 services32 patients

Hospital Affiliations CMS Care Compare 3

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

King's Daughters' Medical Center

Acute Care Hospitals · Ashland, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180009

Location2201 Lexington AvenueAshland, KY 41101 · Boyd County

Emergency services

St Mary's Medical Center

Acute Care Hospitals · Huntington, WV

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number510007

Location2900 1st AvenueHuntington, WV 25702 · Cabell County

Emergency services

Cabell Huntington Hospital, Inc

Acute Care Hospitals · Huntington, WV

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510055

Location1340 Hal Greer BoulevardHuntington, WV 25701 · Cabell County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25701 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

$164.59 typical visit price

range $53.20 – $164.59

Typical copayment $41.14 (range $13.30 – $41.14)

Most-billed visit code 99205

Established Patient

$94.81 typical visit price

range $16.47 – $133.29

Typical copayment $23.70 (range $4.11 – $33.32)

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.

29.83/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Improvement Activities

Cost

16.67

Referred Medical Equipment & Supplies CMS DME claims 10

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

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221

DME-Other DME · category DE017N

2 suppliers35 claims35 services$18.91 avg. paid by Medicare

Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222

DME-Medical/Surgical Supplies · category DA000N

2 suppliers35 claims35 services$36.56 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$14.92 avg. paid by Medicare

Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630

DME-Other DME · category DE000N

1 supplier12 claims12 services$35.28 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$67.87 avg. paid by Medicare

Capecitabine, oral, 150 mg J8520

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier30 claims1,022 services$0.36 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

SCOTT W MITCHELL MD

Family Medicine (Hospice and Palliative Medicine)