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JAMES DALE TOOMBS M.D.
NPI 1417916222
Family Medicine in Ballwin, MO

Active since March 21, 2006PECOS EnrolledAccepts Medicare Assignment
1348 RUSTICVIEW DR, BALLWIN, MO 63011(573) 823-8066 Get Directions Write a Review

NPPES record last updated: September 29, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About James Dale Toombs M.d. NPPES

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

JAMES DALE TOOMBS M.D. (NPI 1417916222) is an individual family medicine provider in Ballwin, Missouri, licensed in Missouri (2001014708) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1417916222
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJAMES DALE TOOMBSCredential: M.D.
Location Address1348 RUSTICVIEW DRBallwin, MO 63011-4271
Mailing Address1348 Rusticview DrBallwin, MO 63011-4271 · (573) 823-8066
Phone(573) 823-8066
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateMarch 21, 2006
Last NPPES UpdateSeptember 29, 2023
NPPES CertifiedSeptember 29, 2023
✔ NPI 1417916222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MO · 2001014708
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPhysical Medicine & Rehabilitation · Pain MedicineTaxonomy 2081P2900X · License 2001014708 (MO)
1348 RUSTICVIEW DR, Ballwin, MO 63011
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James Dale Toombs 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 ID547511289
PECOS Enrollment IDI20180919003507
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.

Medicare Billing Reassignments

2

Medicare enrollment records show James Toombs reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mercy East Ambulatory Services LLC
3.9 mi
Urgent Care
1722 CLARKSON RD
Chesterfield, MO 63017
  • Reassigned Medicare billing, Missouri enrollment
  • 169 clinicians in this Medicare group
NPI 1134673148 (636) 206-2665
Our Urgent Care, LLC
24 mi
Urgent Care
1111 W PEARCE BLVD
Wentzville, MO 63385
  • Reassigned Medicare billing, Missouri enrollment
  • 46 clinicians in this Medicare group
NPI 1902815863 (252) 813-9104

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

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 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.
52 services52 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.
28 services28 patients
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811
This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
23 services23 patients
X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
14 services14 patients
Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63011 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
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.

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 James Toombs's NPI number?

The NPI number for James Toombs is 1417916222. It was assigned to this individual provider in the NPPES registry on March 21, 2006.

Where is James Toombs located?

James Toombs practices at 1348 Rusticview Dr, Ballwin, MO 63011. The listed phone number is (573) 823-8066.

What is James Toombs's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is James Toombs enrolled in Medicare?

Yes. James Toombs 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.

Which organizations bill Medicare for James Toombs's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Toombs reassigns Medicare benefits to 2 organizations: Mercy East Ambulatory Services LLC (Chesterfield, MO) and Our Urgent Care, LLC (Wentzville, MO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Toombs's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Toombs accept?

Health plans from Anthem Blue Cross and Blue Shield list James Toombs 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 James Toombs was last updated on September 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.