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TONI LORAINE HERO D.O.
NPI 1851387849
Family Medicine in Gresham, OR

Active since September 23, 2005PECOS EnrolledAccepts Medicare Assignment
82.03/100
CMS Quality Rating
400 NE ROBERTS AVE, GRESHAM, OR 97030(503) 665-9144(503) 665-6404 Get Directions Write a Review

NPPES record last updated: October 10, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Toni Loraine Hero D.o. NPPES

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

TONI LORAINE HERO D.O. (NPI 1851387849) is an individual family medicine provider in Gresham, Oregon, licensed in Oregon (DO18839) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS, is affiliated with Asante Rogue Regional Medical Center, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1851387849
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameTONI LORAINE HEROCredential: D.O.
Location Address400 NE ROBERTS AVEGresham, OR 97030-7464
Mailing Address400 Ne Roberts AveGresham, OR 97030-7464 · (503) 665-9144 · Fax (503) 665-6404
Phone(503) 665-9144
Fax(503) 665-6404
Sole ProprietorNo
Medical School CMSOtherGraduated 1993
Enumeration DateSeptember 23, 2005
Last NPPES UpdateOctober 10, 2007
✔ NPI 1851387849 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OR · DO18839
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
400 NE ROBERTS AVE, Gresham, OR 97030
Open in Google Maps ↗

Other Identifiers 3

Medicare UPING23129OR
Medicare ID-Type Unspecified118823OR
Medicaid079546OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan 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

Toni Loraine Hero 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 ID6901889443
PECOS Enrollment IDI20040608000180
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 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.
133 services85 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.
103 services66 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.
97 services72 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
47 services47 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.
33 services24 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
16 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Asante Rogue Regional Medical Center

Acute Care Hospitals · Medford, OR
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380018
Location2825 E Barnett RoadMedford, OR 97504 · Jackson County
Emergency services Birthing friendly

Legacy Mount Hood Medical Center

Acute Care Hospitals · Gresham, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380025
Location24800 SE Stark StreetGresham, OR 97030 · Multnomah County
Emergency services Birthing friendly

Providence Medford Medical Center

Acute Care Hospitals · Medford, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number380075
Location1111 Crater Lake AvenueMedford, OR 97504 · Jackson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97030 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
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.

82.03/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality91.43
Improvement Activities40
Cost51.53

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.

Hospital bed, variable height, hi-lo, with any type side rails, with mattress E0255
DME-Hospital Beds · category DB000N
1 supplier11 claims11 services$38.72 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 2

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

ROBERTS STREET CLINIC, P.C.
Family Medicine
400 NE ROBERTS AVE
GRESHAM, OR 97030
Multnomah County (503) 669-3066
GORDON PAUL CANZLER D.O.
Family Medicine
400 NE ROBERTS AVE
GRESHAM, OR 97030
Multnomah County (503) 665-9144

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 Toni Hero's NPI number?

The NPI number for Toni Hero is 1851387849. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Where is Toni Hero located?

Toni Hero practices at 400 NE Roberts Ave, Gresham, OR 97030. The listed phone number is (503) 665-9144.

What is Toni Hero's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Toni Hero enrolled in Medicare?

Yes. Toni Hero 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 Toni Hero accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Toni Hero 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 Toni Hero affiliated with any hospitals?

According to CMS data, Toni Hero is affiliated with Asante Rogue Regional Medical Center, Legacy Mount Hood Medical Center and Providence Medford Medical Center.

When was this NPI record last updated?

The NPPES record for Toni Hero was last updated on October 10, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.