DR. JOHN DONALD TOTH D.O.
NPI 1780736348
Orthopaedic Surgery in Gilbert, AZ

Active since January 16, 2007PECOS EnrolledAccepts Medicare Assignment
87.81/100
CMS Quality Rating
1920 N HIGLEY RD STE 206, GILBERT, AZ 85234(480) 543-6700(480) 543-6725 Get Directions Write a Review

NPPES record last updated: April 17, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. John Donald Toth D.o. NPPES

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

DR. JOHN DONALD TOTH D.O. (NPI 1780736348) is an individual orthopaedic surgery provider in Gilbert, Arizona, licensed in Virginia (0102202195) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Mid West Medical College (2003).

NPPES Registry Identity

NPI1780736348
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. JOHN DONALD TOTHCredential: D.O.
Location Address1920 N HIGLEY RD STE 206Gilbert, AZ 85234-1624
Mailing Address1920 N Higley Rd Ste 206Gilbert, AZ 85234-1624 · (480) 543-6700 · Fax (480) 543-6725
Fax(480) 543-6725
Sole ProprietorYes
Medical School CMSMid West Medical CollegeGraduated 2003
Enumeration DateJanuary 16, 2007
Last NPPES UpdateApril 17, 2015
NPI 1780736348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in VA · 0102202195
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1920 N HIGLEY RD STE 206, Gilbert, AZ 85234

Other Identifiers 2

Medicare PINZ131703AZ
Medicaid1780736348VA

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

Dr. John Donald Toth D.o. 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 ID1153496484
PECOS Enrollment IDI20090825000689
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 17

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
676 services149 patients
X-ray of shoulder, minimum of 2 views 73030
An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
296 services251 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
158 services151 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.
150 services150 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.
150 services116 patients
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.
70 services68 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85234 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
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.

87.81/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability99
Improvement Activities40
Cost61.22

Referred Medical Equipment & Supplies CMS DME claims

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

Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf L3670
DME-Orthotic Devices · category DF000N
1 supplier52 claims52 services$111.88 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 6

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

Podiatrist (Foot & Ankle Surgery)
1920 N HIGLEY RD STE 206
GILBERT, AZ 85234
Orthopaedic Surgery (Hand Surgery)
1920 N HIGLEY RD STE 206
GILBERT, AZ 85234
Physician Assistant
1920 N HIGLEY RD STE 206
GILBERT, AZ 85234
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
1920 N HIGLEY RD STE 206
GILBERT, AZ 85234
Physician Assistant
1920 N HIGLEY RD STE 206
GILBERT, AZ 85234
Orthopaedic Surgery
1920 N HIGLEY RD STE 206
GILBERT, AZ 85234

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 John Toth's NPI number?

The NPI number for John Toth is 1780736348. It was assigned to this individual provider in the NPPES registry on January 16, 2007.

Where is John Toth located?

John Toth practices at 1920 N Higley Rd Ste 206, Gilbert, AZ 85234. The listed phone number is (480) 543-6700.

What is John Toth's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is John Toth enrolled in Medicare?

Yes. John Toth 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 John Toth accept?

Health plans from Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and UnitedHealthcare list John Toth 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 John Toth was last updated on April 17, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.