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DR. CLAUDE H TOLBERT JR. MD
NPI 1922026350
Obstetrics & Gynecology - Gynecology in Bluffton, SC

Active since July 17, 2006PECOS EnrolledAccepts Medicare Assignment
75 BAYLOR DR, SUITE 200, BLUFFTON, SC 29910(843) 540-5857(843) 524-5655 Get Directions Write a Review

NPPES record last updated: December 8, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Claude H Tolbert Jr. Md NPPES

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

DR. CLAUDE H TOLBERT JR. MD (NPI 1922026350) is an individual gynecology provider in Bluffton, South Carolina, licensed in South Carolina (22002) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Beaufort County Memorial Hospital, and is a graduate of Meharry Medical College School Of Medicine (1996).

NPPES Registry Identity

NPI1922026350
Entity TypeIndividualMale
Primary Taxonomy207VG0400X
Provider Legal NameDR. CLAUDE H TOLBERT JR.Credential: MD
Location Address75 BAYLOR DR, SUITE 200Bluffton, SC 29910-8965
Mailing Address75 Baylor Dr, Suite 200Bluffton, SC 29910-8965 · (843) 540-5857 · Fax (843) 524-5655
Phone(843) 540-5857
Fax(843) 524-5655
Sole ProprietorNo
Medical School CMSMeharry Medical College School Of MedicineGraduated 1996
Enumeration DateJuly 17, 2006
Last NPPES UpdateDecember 8, 2016
✔ NPI 1922026350 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207VG0400X
License✔ Licensed in SC · 22002
Definition
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee
75 BAYLOR DR, Bluffton, SC 29910
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Other Identifiers 3

Medicare UPINH13701SC
MedicaidT59032SC
Medicare ID-Type UnspecifiedH13701 8067SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, First Choice Next 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

Dr. Claude H Tolbert Jr. 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 ID2567446396
PECOS Enrollment IDI20040617000833
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 4

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.
29 services21 patients
Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
23 services23 patients
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory Q0091
A Papanicolaou smear, often called a Pap smear, is a test to check for changes in cells. A small sample is gently collected from the lower region and sent to a lab for examination. This helps in early detection of potential health issues.
17 services17 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.
15 services15 patients

Hospital Affiliations CMS Care Compare 3

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

Beaufort County Memorial Hospital

Acute Care Hospitals · Beaufort, SC
4/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number420067
Location955 Ribaut RdBeaufort, SC 29902 · Beaufort County
Emergency services Birthing friendly

Hilton Head Regional Medical Center

Acute Care Hospitals · Hilton Head Island, SC
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number420080
Location25 Hospital Center BlvdHilton Head Island, SC 29925 · Beaufort County
Emergency services Birthing friendly

Coastal Carolina Hospital

Acute Care Hospitals · Hardeeville, SC
2/5 CMS rating
OwnershipProprietary
CMS Certification Number420101
Location1000 Medical Center DriveHardeeville, SC 29927 · Jasper County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29910 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
$124.04 typical visit price
range $53.57 – $163.84
Typical copayment $31.01 (range $13.39 – $40.96)
Most-billed visit code 99204
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
67%87 patients3/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
91%612 patients
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.
95%1,040 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
31%293 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%183 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
24%1,252 patients2/55-star benchmark: 97%
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…
37%467 patients2/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 98% · 497 patients
Patients tobacco: 35% · 48 patients
91%497 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
92%1,252 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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
53%1,252 patients3/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
56%1,252 patients
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.

Other Providers at the Same Location NPPES 10

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

HILTON HEAD REGIONAL PHYSICIAN GROUP LLC
Surgery
75 BAYLOR DR
BLUFFTON, SC 29910
Beaufort County (843) 682-7480
HILTON HEAD REGIONAL PHYSICIAN GROUP LLC
Surgery
75 BAYLOR DR
BLUFFTON, SC 29910
Beaufort County (843) 682-7480
ARDRA R DAVIS-TOLBERT MD
Obstetrics & Gynecology
75 BAYLOR DR, STE 200
BLUFFTON, SC 29910
Beaufort County (843) 540-5857
MS. DIANE C COLLINS PT CHT
Physical Therapist
75 BAYLOR DR
BLUFFTON, SC 29910
Beaufort County (843) 476-4682
GEORGE W WARNER MD
Psychiatry & Neurology (Neurology)
75 BAYLOR DR, #155
BLUFFTON, SC 29910
Beaufort County (843) 836-3667
KAYO PERLEY MD
Family Medicine
75 BAYLOR DR
BLUFFTON, SC 29910
Beaufort County (843) 836-4262
JEREMY P HATCH M.D.
Orthopaedic Surgery
75 BAYLOR DR, SUITE 155
BLUFFTON, SC 29910
Beaufort County (843) 682-7480
DR. JASON WILLIAM COTTER M.D.
Surgery
75 BAYLOR DR, SUITE 290
BLUFFTON, SC 29910
Beaufort County (843) 705-8919

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 Claude Tolbert's NPI number?

The NPI number for Claude Tolbert is 1922026350. It was assigned to this individual provider in the NPPES registry on July 17, 2006.

Where is Claude Tolbert located?

Claude Tolbert practices at 75 Baylor Dr Suite 200, Bluffton, SC 29910. The listed phone number is (843) 540-5857.

What is Claude Tolbert's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecology, with taxonomy code 207VG0400X.

Is Claude Tolbert enrolled in Medicare?

Yes. Claude Tolbert 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 Claude Tolbert accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, First Choice Next, Molina Healthcare and UnitedHealthcare list Claude Tolbert 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 Claude Tolbert affiliated with any hospitals?

According to CMS data, Claude Tolbert is affiliated with Beaufort County Memorial Hospital, Hilton Head Regional Medical Center and Coastal Carolina Hospital.

When was this NPI record last updated?

The NPPES record for Claude Tolbert was last updated on December 8, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.