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TODD A SPONSLER M.D.
NPI 1497728935
Ophthalmology in Altoona, PA

Active since February 07, 2006PECOS EnrolledAccepts Medicare Assignment
76.18/100
CMS Quality Rating
600 E. PLEASANT VALLEY BLVD, ALTOONA, PA 16602(814) 946-0821(814) 941-2520 Get Directions Write a Review

NPPES record last updated: January 11, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Todd A Sponsler M.d. NPPES

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

TODD A SPONSLER M.D. (NPI 1497728935) is an individual ophthalmology provider in Altoona, Pennsylvania, licensed in Pennsylvania (MD052425L) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Penn Highlands Tyrone, and is a graduate of Pennsylvania State University College Of Medicine (1990).

NPPES Registry Identity

NPI1497728935
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameTODD A SPONSLERCredential: M.D.
Location Address600 E. PLEASANT VALLEY BLVDAltoona, PA 16602-5530
Mailing Address600 E. Pleasant Valley BlvdAltoona, PA 16602-5530 · (814) 946-0821 · Fax (814) 941-2520
Phone(814) 946-0821
Fax(814) 941-2520
Sole ProprietorNo
Medical School CMSPennsylvania State University College Of MedicineGraduated 1990
Enumeration DateFebruary 7, 2006
Last NPPES UpdateJanuary 11, 2012
✔ NPI 1497728935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in PA · MD052425L
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
600 E. PLEASANT VALLEY BLVD, Altoona, PA 16602
Open in Google Maps ↗

Other Identifiers 3

Medicare ID-Type Unspecified769876PA
Medicare UPINF80399PA
Medicaid0014681390005PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming, Highmark Blue Cross Blue Shield Delaware 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

Todd A Sponsler 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 ID1254503592
PECOS Enrollment IDI20111011000430
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 8

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.
534 services472 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.
159 services134 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
149 services103 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.
135 services96 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
134 services132 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
48 services47 patients

Hospital Affiliations CMS Care Compare

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

Penn Highlands Tyrone

Critical Access Hospitals · Tyrone, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number391307
Location187 Hospital DriveTyrone, PA 16686 · Blair County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16602 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
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.

76.18/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost20.63

Other Providers at the Same Location NPPES 3

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

RENEE L JONES MD
Ophthalmology
600 E. PLEASANT VALLEY BLVD
ALTOONA, PA 16602
Blair County (814) 946-0821
ROBERT M BUDD M.D.
Ophthalmology
600 E. PLEASANT VALLEY BLVD
ALTOONA, PA 16602
Blair County (814) 946-0821
ROBERT T BECHTEL M.D.
Ophthalmology
600 E. PLEASANT VALLEY BLVD
ALTOONA, PA 16602
Blair County (814) 946-0821

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 Todd Sponsler's NPI number?

The NPI number for Todd Sponsler is 1497728935. It was assigned to this individual provider in the NPPES registry on February 7, 2006.

Where is Todd Sponsler located?

Todd Sponsler practices at 600 E. Pleasant Valley Blvd, Altoona, PA 16602. The listed phone number is (814) 946-0821.

What is Todd Sponsler's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Todd Sponsler enrolled in Medicare?

Yes. Todd Sponsler 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 Todd Sponsler accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Highmark Blue Cross Blue Shield Delaware and Highmark Blue Cross Blue Shield West Virginia list Todd Sponsler 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 Todd Sponsler affiliated with any hospitals?

According to CMS data, Todd Sponsler is affiliated with Penn Highlands Tyrone.

When was this NPI record last updated?

The NPPES record for Todd Sponsler was last updated on January 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.