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DR. THOMAS O'TOOLE MD
NPI 1841834140
Internal Medicine in Durham, NC

Active since October 30, 2019PECOS EnrolledAccepts Medicare Assignment
2301 ERWIN RD, DURHAM, NC 27710(503) 494-8428 Get Directions Write a Review

NPPES record last updated: August 7, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 7, 2024, Jul 7, 2021, Oct 30, 2019 (3 updates tracked since 2019).

About Dr. Thomas O'toole Md NPPES

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

DR. THOMAS O'TOOLE MD (NPI 1841834140) is an individual internal medicine provider in Durham, North Carolina, licensed in North Carolina (2024-02243) and active in the NPI registry since October 2019. He is enrolled in Medicare PECOS, is affiliated with Duke University Hospital, and is a graduate of Oregon Health Sciences University School Of Medicine (2021).

NPPES Registry Identity

NPI1841834140
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. THOMAS O'TOOLECredential: MD
Location Address2301 ERWIN RDDurham, NC 27710-5042
Mailing Address2301 Erwin RdDurham, NC 27705-4699
Phone(503) 494-8428
Sole ProprietorNo
Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2021
Enumeration DateOctober 30, 2019
Last NPPES UpdateAugust 7, 20243 updates tracked since enumeration
NPPES CertifiedAugust 7, 2024
✔ NPI 1841834140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NC · 2024-02243
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2301 ERWIN RD, Durham, NC 27710
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Thomas O'toole 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 ID5799188025
PECOS Enrollment IDI20241018000833
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.

Medicare Billing Reassignment

Medicare enrollment records show Thomas O'toole reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Duke University Health System, Inc.
3.0 mi
Internal Medicine
3643 N ROXBORO ST
Durham, NC 27704
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,482 clinicians in this Medicare group
NPI 1376574798 (919) 470-8490

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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.

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.
22 services22 patients

Hospital Affiliations CMS Care Compare

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

Duke University Hospital

Acute Care Hospitals · Durham, NC
5/5 CMS rating
OwnershipProprietary
CMS Certification Number340030
Location2100 Erwin RdDurham, NC 27705 · Durham County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27710 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

Other Providers at the Same Location NPPES 20

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

CANDICE MARLOW RAY M.D.
Pediatrics (Pediatric Critical Care Medicine)
2301 ERWIN RD
DURHAM, NC 27710
Durham County (919) 684-8111
AMY KATHERINE TALLY PT, DPT
Physical Therapist
2301 ERWIN RD
DURHAM, NC 27710
Durham County (919) 684-8111
MRS. ALICIA HISCOX PARISI RN, NNP-BC
Nurse Practitioner (Neonatal)
2301 ERWIN RD
DURHAM, NC 27710
Durham County (919) 681-3501
DR. NICHOLAS PARRISH M.D.
Surgery
2301 ERWIN RD
DURHAM, NC 27710
Durham County (919) 613-6133
DR. LARRY RONALD JACKSON II M.D.
Internal Medicine (Clinical Cardiac Electrophysiology)
2301 ERWIN RD
DURHAM, NC 27710
Durham County (919) 970-6972
ERIN P BROUSH NNP-BC
Nurse Practitioner (Neonatal)
2301 ERWIN RD
DURHAM, NC 27710
Durham County (919) 681-5551
DAVID SLADE M.D.
Student in an Organized Health Care Education/Training Program
2301 ERWIN RD
DURHAM, NC 27710
Durham County (919) 970-8293
DR. KEVIN CARL GENGEL M.D.
Radiology (Diagnostic Radiology)
2301 ERWIN RD
DURHAM, NC 27710
Durham County (919) 684-1111

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 Thomas O'toole's NPI number?

The NPI number for Thomas O'toole is 1841834140. It was assigned to this individual provider in the NPPES registry on October 30, 2019.

Where is Thomas O'toole located?

Thomas O'toole practices at 2301 Erwin Rd, Durham, NC 27710. The listed phone number is (503) 494-8428.

What is Thomas O'toole's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Thomas O'toole enrolled in Medicare?

Yes. Thomas O'toole 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.

Which organization bills Medicare for Thomas O'toole's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas O'toole reassigns Medicare benefits to Duke University Health System, Inc. (Durham, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thomas O'toole's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Thomas O'toole accept?

Health plans from Cigna Healthcare list Thomas O'toole 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 Thomas O'toole affiliated with any hospitals?

According to CMS data, Thomas O'toole is affiliated with Duke University Hospital.

When was this NPI record last updated?

The NPPES record for Thomas O'toole was last updated on August 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.