PETER TOTH M.D.
NPI 1861572869
Family Medicine in Sterling, IL

Q: What is Peter Toth's NPI number?

The NPI number for Peter Toth is 1861572869. It was assigned to this individual provider in the NPPES registry on October 16, 2006.

Q: What is Peter Toth's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Peter Toth was last updated on July 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since October 16, 2006PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

101 E MILLER RD, STERLING, IL 61081(815) 625-4790 Get Directions Write a Review

NPPES record last updated: July 7, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Peter Toth M.d. NPPES

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

PETER TOTH M.D. (NPI 1861572869) is an individual family medicine provider in Sterling, Illinois, licensed in Illinois (036061910) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Katherine Shaw Bethea Hospital, and is a graduate of Wayne State University School Of Medicine (1992).

NPPES Registry Identity

NPI1861572869

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NamePETER TOTHCredential: M.D.

Location Address101 E MILLER RDSterling, IL 61081-1252

Mailing Address101 E Miller RdSterling, IL 61081-1252 · (815) 625-4790

Phone(815) 625-4790

Sole ProprietorNo

Medical School CMSWayne State University School Of MedicineGraduated 1992

Enumeration DateOctober 16, 2006

Last NPPES UpdateJuly 7, 2021

NPPES CertifiedJuly 7, 2021

✔ NPI 1861572869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 036061910

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.

101 E MILLER RD, Sterling, IL 61081

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Other Identifiers 4

Medicaid036092906IL

Other075899IL · Health Alliance Plan

Other080173864Railroad Medicare

Other9815737IL · Blue Cross Blue Shield

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

Peter Toth M.d. 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 ID6709785744

PECOS Enrollment IDI20100913001112

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.

1,358 services437 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.

220 services159 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

29 services27 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.

19 services11 patients

Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm 11402

This procedure involves the removal of a noncancerous skin growth on the body, arms, or legs that is between 1.1 and 2.0 cm in size. It's a safe and routine procedure performed by a medical professional to improve your skin health and appearance.

18 services12 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

18 services17 patients

Hospital Affiliations CMS Care Compare 2

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

Katherine Shaw Bethea Hospital

Acute Care Hospitals · Dixon, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140012

Location403 E 1st StDixon, IL 61021 · Lee County

Emergency services Birthing friendly

Cgh Medical Center

Acute Care Hospitals · Sterling, IL

2/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number140043

Location100 East Lefevre RoadSterling, IL 61081 · Whiteside County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61081 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Referred Medical Equipment & Supplies CMS DME claims 16

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

9 suppliers76 claims206 services$6.36 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

9 suppliers38 claims46 services$1.09 avg. paid by Medicare

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

DME-Other DME · category DE001N

2 suppliers24 claims24 services$43.00 avg. paid by Medicare

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

DME-Other DME · category DE001N

4 suppliers20 claims90 services$23.92 avg. paid by Medicare

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

DME-Other DME · category DE001N

1 supplier13 claims36 services$18.95 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

4 suppliers25 claims25 services$74.72 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 20

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

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