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DERRICK S TOOTH MD
NPI 1639260847
Urology in Manchester, ME

Active since September 27, 2006PECOS EnrolledAccepts Medicare Assignment
79.27/100
CMS Quality Rating
1053 WESTERN AVE, MANCHESTER, ME 04351(207) 622-6319(207) 622-6654 Get Directions Write a Review

NPPES record last updated: December 5, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Derrick S Tooth Md NPPES

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

DERRICK S TOOTH MD (NPI 1639260847) is an individual urology provider in Manchester, Maine, licensed in Maine (014663) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Maine General Medical Center, and is a graduate of Other (1991).

NPPES Registry Identity

NPI1639260847
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameDERRICK S TOOTHCredential: MD
Location Address1053 WESTERN AVEManchester, ME 04351-3403
Mailing Address9 Pleasant Street, Suite 2Oakland, ME 04963 · (207) 465-2700 · Fax (207) 465-2300
Phone(207) 622-6319
Fax(207) 622-6654
Sole ProprietorNo
Medical School CMSOtherGraduated 1991
Enumeration DateSeptember 27, 2006
Last NPPES UpdateDecember 5, 2012
✔ NPI 1639260847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in ME · 014663
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
1053 WESTERN AVE, Manchester, ME 04351
Open in Google Maps ↗

Other Identifiers 5

Medicare ID-Type UnspecifiedMM7138ME
Other030440ME · Anthem
Medicaid255890099ME
Medicare UPING67705
Other1041053Aetna

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derrick S Tooth 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 ID1153368253
PECOS Enrollment IDI20050411000699
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 6

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.
261 services183 patients
Diagnostic exam of bladder and urethra using an endoscope 52000
This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.
111 services82 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.
61 services49 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
33 services33 patients
Biopsy of prostate gland 55700
A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.
27 services27 patients
Ultrasound scan of pelvic region through rectum 76872
An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.
27 services27 patients

Hospital Affiliations CMS Care Compare 3

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

Maine General Medical Center

Acute Care Hospitals · Augusta, ME
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number200039
Location35 Medical Center ParkwayAugusta, ME 04330 · Kennebec County
Emergency services Birthing friendly

Penobscot Bay Medical Center

Acute Care Hospitals · Rockport, ME
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200063
Location6 Glen Cove DriveRockport, ME 04856 · Knox County
Emergency services Birthing friendly

Waldo County General Hospital

Critical Access Hospitals · Belfast, ME
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number201312
Location118 Northport AveBelfast, ME 04915 · Waldo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04351 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
$123.23 typical visit price
range $53.26 – $162.77
Typical copayment $30.80 (range $13.31 – $40.69)
Most-billed visit code 99204
Established Patient
$66.74 typical visit price
range $16.90 – $132.79
Typical copayment $16.68 (range $4.22 – $33.19)
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.

79.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.72
Promoting Interoperability76
Improvement Activities40
Cost60.51

Referred Medical Equipment & Supplies CMS DME claims 2

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

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
3 suppliers18 claims3,360 services$1.70 avg. paid by Medicare
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352
DME-Orthotic Devices · category DF008N
2 suppliers11 claims2,250 services$6.09 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

NORTHERN NEW ENGLAND DIAGNOSTICS
Clinical Medical Laboratory
1053 WESTERN AVE
MANCHESTER, ME 04351
Kennebec County (207) 622-4500

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 Derrick Tooth's NPI number?

The NPI number for Derrick Tooth is 1639260847. It was assigned to this individual provider in the NPPES registry on September 27, 2006.

Where is Derrick Tooth located?

Derrick Tooth practices at 1053 Western Ave, Manchester, ME 04351. The listed phone number is (207) 622-6319.

What is Derrick Tooth's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Derrick Tooth enrolled in Medicare?

Yes. Derrick Tooth 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 Derrick Tooth accept?

Health plans from Anthem Blue Cross and Blue Shield list Derrick Tooth 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 Derrick Tooth affiliated with any hospitals?

According to CMS data, Derrick Tooth is affiliated with Maine General Medical Center, Penobscot Bay Medical Center and Waldo County General Hospital.

When was this NPI record last updated?

The NPPES record for Derrick Tooth was last updated on December 5, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.