CAROL TOUMA
NPI 1659597466
Internal Medicine - Endocrinology, Diabetes & Metabolism in Louisville, KY

Active since April 18, 2007PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
2355 POPLAR LEVEL RD STE 301, LOUISVILLE, KY 40217(502) 559-3636(502) 636-5137 Get Directions Write a Review

NPPES record last updated: September 27, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Sep 27, 2024, Jan 22, 2021, Oct 27, 2020 and 1 more (4 updates tracked since 2020).

About Carol Touma NPPES

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

CAROL TOUMA (NPI 1659597466) is an individual endocrinology, diabetes & metabolism provider in Louisville, Kentucky, licensed in Illinois (036120532) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS, is affiliated with Norton Hospitals, Inc, and is a graduate of University Of Kentucky College Of Medicine (2005).

NPPES Registry Identity

NPI1659597466
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameCAROL TOUMA
Location Address2355 POPLAR LEVEL RD STE 301Louisville, KY 40217-1388
Mailing AddressPo Box 776351Chicago, IL 60677-6351 · (502) 588-9490 · Fax (502) 272-5116
Fax(502) 636-5137
Sole ProprietorYes
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 2005
Enumeration DateApril 18, 2007
Last NPPES UpdateSeptember 27, 20244 updates tracked since enumeration
NPPES CertifiedSeptember 27, 2024
NPI 1659597466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License Licensed in IL · 036120532
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedInternal MedicineTaxonomy 207R00000X · License LP00443 (RI)
2355 POPLAR LEVEL RD STE 301, Louisville, KY 40217

Accepted 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

Carol Touma 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 ID4789747296
PECOS Enrollment IDI20190311000140
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.
317 services208 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
204 services153 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
102 services67 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
62 services27 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.
36 services36 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
16 services16 patients

Hospital Affiliations CMS Care Compare 2

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

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180088
Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County
Emergency services Birthing friendly

University Of Louisville Hospital

Acute Care Hospitals · Louisville, KY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180141
Location530 South Jackson StreetLouisville, KY 40202 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40217 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
15 suppliers37 claims167 services$6.51 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers12 claims25 services$1.06 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
6 suppliers81 claims82 services$183.85 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 7

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

Internal Medicine (Endocrinology, Diabetes & Metabolism)
2355 POPLAR LEVEL RD STE 301
LOUISVILLE, KY 40217
Dietitian, Registered
2355 POPLAR LEVEL RD STE 301
LOUISVILLE, KY 40217
Nurse Practitioner
2355 POPLAR LEVEL RD STE 301
LOUISVILLE, KY 40217
Nurse Practitioner (Family)
2355 POPLAR LEVEL RD STE 301
LOUISVILLE, KY 40217
Dietitian, Registered
2355 POPLAR LEVEL RD STE 301
LOUISVILLE, KY 40217
Internal Medicine (Endocrinology, Diabetes & Metabolism)
2355 POPLAR LEVEL RD STE 301
LOUISVILLE, KY 40217
Dietitian, Registered
2355 POPLAR LEVEL RD STE 301
LOUISVILLE, KY 40217

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 Carol Touma's NPI number?

The NPI number for Carol Touma is 1659597466. It was assigned to this individual provider in the NPPES registry on April 18, 2007.

Where is Carol Touma located?

Carol Touma practices at 2355 Poplar Level Rd Ste 301, Louisville, KY 40217. The listed phone number is (502) 559-3636.

What is Carol Touma's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Carol Touma enrolled in Medicare?

Yes. Carol Touma 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 Carol Touma accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Carol Touma 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 Carol Touma affiliated with any hospitals?

According to CMS data, Carol Touma is affiliated with Norton Hospitals, Inc and University Of Louisville Hospital.

When was this NPI record last updated?

The NPPES record for Carol Touma was last updated on September 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.