MICHAEL P TONNER MD
NPI 1740280122
Internal Medicine - Pulmonary Disease in Sebastian, FL

Q: What is Michael Tonner's NPI number?

The NPI number for Michael Tonner is 1740280122. It was assigned to this individual provider in the NPPES registry on July 27, 2005.

Q: What is Michael Tonner's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Michael Tonner was last updated on March 31, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 27, 2005PECOS EnrolledAccepts Medicare Assignment

12920 US HIGHWAY 1 STE A, SEBASTIAN, FL 32958(772) 388-8322(772) 388-8323 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 31, 2025, Feb 25, 2021, Feb 2, 2021 and 3 more (6 updates tracked since 2016).

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About Michael P Tonner Md NPPES

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

MICHAEL P TONNER MD (NPI 1740280122) is an individual pulmonary disease provider in Sebastian, Florida, licensed in Florida (ME0064234) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Orlando Health, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1740280122

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameMICHAEL P TONNERCredential: MD

Location Address12920 US HIGHWAY 1 STE ASebastian, FL 32958-3772

Mailing Address12920 Us Highway 1 Ste ASebastian, FL 32958-3772 · (772) 388-8322 · Fax (772) 388-8323

Phone(772) 388-8322

Fax(772) 388-8323

Sole ProprietorYes

Medical School CMSIndiana University School Of MedicineGraduated 1987

Enumeration DateJuly 27, 2005

Last NPPES UpdateMarch 31, 20256 updates tracked since enumeration

NPPES CertifiedMarch 31, 2025

✔ NPI 1740280122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

Licenses✔ Licensed in FL · ME0064234✔ Licensed in NH · LT-4241

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedSpecialistTaxonomy 174400000X · License ME0064234 (FL)

12920 US HIGHWAY 1 STE A, Sebastian, FL 32958

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Secondary Practice Locations 2

Location 13735 11th Cir, Suite 103Vero Beach, FL 32960-4844 · Phone (772) 770-4888 · Fax (772) 770-0190

Location 2246 Pleasant St., Memorial Building, West, Ground FloorConcord, NH 03301-2548 · Phone (603) 224-9661 · Fax (603) 227-7528

Other Identifiers 1

Medicaid112583400FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama 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

Michael P Tonner 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 ID3577698877

PECOS Enrollment IDI20100311000670

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 15

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.

410 services229 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.

174 services144 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

97 services96 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

94 services48 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

93 services47 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

91 services90 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

90 services89 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.

74 services50 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.

51 services46 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.

40 services40 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

33 services33 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.

25 services25 patients

Aspiration of fluid from chest cavity using imaging guidance 32555

This procedure, known as a thoracentesis, involves removing fluid from the space between the lungs and chest wall, called the pleural space. It's performed under imaging guidance to ensure precision. It can help diagnose conditions or relieve symptoms like shortness of breath.

23 services22 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

19 services12 patients

Ultrasonic guidance for blood vessel access 76937

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

13 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Orlando Health

Acute Care Hospitals · Orlando, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100006

Location52 W Underwood StOrlando, FL 32806 · Orange County

Emergency services Birthing friendly

Cleveland Clinic Indian River Hospital

Acute Care Hospitals · Vero Beach, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100105

Location1000 36th StVero Beach, FL 32960 · Indian River County

Emergency services Birthing friendly

Sebastian River Medical Center

Acute Care Hospitals · Sebastian, FL

3/5 CMS rating

OwnershipProprietary

CMS Certification Number100217

Location13695 Us Hwy 1Sebastian, FL 32958 · Indian River County

Emergency services

Melbourne Regional Medical Center

Acute Care Hospitals · Melbourne, FL

2/5 CMS rating

OwnershipProprietary

CMS Certification Number100291

Location250 North Wickham RoadMelbourne, FL 32935 · Brevard County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32958 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

$135.56 typical visit price

range $58.56 – $179.05

Typical copayment $33.89 (range $14.64 – $44.76)

Most-billed visit code 99204

Established Patient

$103.21 typical visit price

range $18.44 – $144.68

Typical copayment $25.80 (range $4.61 – $36.17)

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.

Reported Quality Measures

Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation

Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented

23%295 patients1/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%1,454 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

3%288 patients1/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

44%568 patients2/55-star benchmark: 95%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

39%711 patients2/55-star benchmark: 100%

Provide Patient Access

For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…

99%281 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…

4%281 patients1/55-star benchmark: 77%

Send a Summary of Care

For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2)…

36%28 patients2/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 24

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

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

8 suppliers59 claims59 services$36.88 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

7 suppliers29 claims29 services$84.20 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

6 suppliers24 claims59 services$33.94 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

6 suppliers15 claims61 services$19.95 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

7 suppliers19 claims93 services$15.10 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

12 suppliers58 claims58 services$57.12 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

14 suppliers56 claims56 services$17.80 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

8 suppliers30 claims30 services$14.41 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

13 suppliers93 claims327 services$2.24 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

12 suppliers42 claims42 services$11.98 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

6 suppliers76 claims77 services$15.78 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

3 suppliers31 claims31 services$905.96 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

4 suppliers29 claims29 services$13.08 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

3 suppliers22 claims23 services$6.19 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

7 suppliers94 claims94 services$36.07 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

9 suppliers335 claims342 services$85.88 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

5 suppliers148 claims150 services$32.69 avg. paid by Medicare

Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605

DME-Drugs Administered Through DME · category DG006N

2 suppliers12 claims720 services$5.55 avg. paid by Medicare

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606

DME-Drugs Administered Through DME · category DG006N

2 suppliers15 claims1,260 services$6.41 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

7 suppliers24 claims4,087 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

6 suppliers16 claims1,950 services$0.09 avg. paid by Medicare

Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677

DME-Drugs Administered Through DME · category DG006N

2 suppliers14 claims84,000 services$0.15 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

3 suppliers52 claims52 services$33.68 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

10 suppliers40 claims40 services$23.77 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 4

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

DR. WILLIAM RUSSELL PHIPPS M.D.

Surgery (Surgical Critical Care)

12920 US HIGHWAY 1 STE A
SEBASTIAN, FL 32958

Indian River County (321) 727-7992

MARGAUX MALONEY

Nurse Practitioner (Family)

12920 US HIGHWAY 1 STE A
SEBASTIAN, FL 32958

Indian River County (772) 388-8322

TAMSIN BLANCHARD ARNP

Nurse Practitioner (Adult Health)

12920 US HIGHWAY 1 STE A
SEBASTIAN, FL 32958

Indian River County (772) 388-8322

STEWARD MEDICAL GROUP, INC

Internal Medicine (Pulmonary Disease)

12920 US HIGHWAY 1 STE A
SEBASTIAN, FL 32958

Indian River County (772) 388-8322

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 Michael Tonner's NPI number?

The NPI number for Michael Tonner is 1740280122. It was assigned to this individual provider in the NPPES registry on July 27, 2005.

Where is Michael Tonner located?

Michael Tonner practices at 12920 Us Highway 1 Ste A, Sebastian, FL 32958. The listed phone number is (772) 388-8322.

What is Michael Tonner's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Michael Tonner enrolled in Medicare?

Yes. Michael Tonner 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 Michael Tonner accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AmeriHealth Caritas Next and AvMed and 6 other insurers list Michael Tonner 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 Michael Tonner affiliated with any hospitals?

According to CMS data, Michael Tonner is affiliated with Orlando Health, Cleveland Clinic Indian River Hospital, Sebastian River Medical Center and Melbourne Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Tonner was last updated on March 31, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.