JUSTIN TOTH PA-C
NPI 1952785131
Physician Assistant - Medical in Wilmington, NC

Q: What is Justin Toth's NPI number?

The NPI number for Justin Toth is 1952785131. It was assigned to this individual provider in the NPPES registry on July 16, 2015.

Q: What is Justin Toth's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Justin Toth was last updated on July 16, 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.

Active since July 16, 2015PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

5115 OLEANDER DR, WILMINGTON, NC 28403(910) 362-1011 Get Directions Write a Review

NPPES record last updated: July 16, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Justin Toth Pa-c NPPES

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

JUSTIN TOTH PA-C (NPI 1952785131) is an individual medical provider in Wilmington, North Carolina, licensed in North Carolina (0010-05859) and active in the NPI registry since July 2015. He is enrolled in Medicare PECOS, is affiliated with Novant Health New Hanover Regional Medical Center, and is a graduate of Eastern Virginia Medical School (2015).

NPPES Registry Identity

NPI1952785131

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameJUSTIN TOTHCredential: PA-C

Location Address5115 OLEANDER DRWilmington, NC 28403-7018

Mailing Address5115 Oleander DrWilmington, NC 28403-7018 · (910) 362-1011

Phone(910) 362-1011

Sole ProprietorYes

Medical School CMSEastern Virginia Medical SchoolGraduated 2015

Enumeration DateJuly 16, 2015

✔ NPI 1952785131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in NC · 0010-05859

5115 OLEANDER DR, Wilmington, NC 28403

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.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

Justin Toth Pa-c 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 ID5395052906

PECOS Enrollment IDI20150915001283

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 7

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.

546 services322 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

91 services80 patients

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.

83 services82 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

78 services78 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.

53 services50 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

35 services30 patients

Hospital Affiliations CMS Care Compare 3

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

Novant Health New Hanover Regional Medical Center

Acute Care Hospitals · Wilmington, NC

2/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number340141

Location2131 S 17th St Box 9000Wilmington, NC 28402 · New Hanover County

Emergency services Birthing friendly

Novant Health Brunswick Medical Center

Acute Care Hospitals · Supply, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number340158

Location1 Medical Center Dr PO Box 139Supply, NC 28462 · Brunswick County

Emergency services Birthing friendly

J Arthur Dosher Memorial Hospital

Critical Access Hospitals · Southport, NC

OwnershipVoluntary non-profit - Other

CMS Certification Number341327

Location924 Howe StSouthport, NC 28461 · Brunswick County

Emergency services

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.

100/100

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

Scored as part of a group practice

Promoting Interoperability

100

Improvement Activities

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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