Active NPI
Toby Johnson, MD
- Orthopaedic Hand Surgery Physician
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- 12294965-1205
- Practice address
- 1055 N 500 W Ste 207
Provo, UT 84604-3305 - Phone
- (801) 373-7350
- Fax
- (801) 429-8085
- NPI assigned
- Nov 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Hand Surgery Physician | 207XS0106X | 12294965-1205 | UT | Primary |
Addresses
Primary practice location
1055 N 500 W Ste 207
Provo, UT 84604-3305
Mailing address
1055 N 500 W
Att Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225
Other practice location 1
3000 N Triumph Blvd Ste 100
Lehi, UT 84043-4999
Phone (801) 373-7351
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00276609 | Other | CA | RAILROAD MEDICARE |
| 0196688 | Other | CA | STATE OF WASHINGTON |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | medreview@reverehealth.com | Central Utah Clinic, P.C. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hand Surgery
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1055 N 500
Provo, UT 84604-3305
Phone (801) 375-4263
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Current | Accepting new patients | |
| Revere Health PC | Current | Accepting new patients |
Locations
3000 N Triumph Blvd
Ste 100
Lehi, UT 84043
Phone (385) 345-3155
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
1055 N 500 W
Ste 205
Provo, UT 84604
Phone (801) 429-8095
1055 N 500 W
Bldg C
Provo, UT 84604
Phone (801) 812-4624
1055 N 500 W
Ste 207
Provo, UT 84604
Phone (801) 375-4263
1055 N 500 W
Ste 121
Provo, UT 84604
Phone (801) 373-3750
1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362
1055 N 500 W
#207
Provo, UT 84604
Phone (801) 375-4263
Networks
- UT PPO D-SNP
- UT PPO
Interoperability endpoints
- tobyjohnson@cuccu.allscriptsdirect.net
- toby.johnson.p1@direct.spocortho.nextgenshare.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Provo, UT
- NPI 1093764805
-
- Multi-Specialty Clinic/Center
- Spanish Fork, UT
- NPI 1851142285
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Provo, UT
- NPI 1114025491
-
- General Acute Care Hospital
- Orem, UT
- NPI 1801903240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1144203258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N 500 W",
"address_2": "ATT CREDENTIALING",
"city": "PROVO",
"state": "UT",
"postal_code": "846043305",
"telephone_number": "801-354-8225",
"fax_number": "801-418-0941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N 500 W STE 207",
"city": "PROVO",
"state": "UT",
"postal_code": "846043305",
"telephone_number": "801-373-7350",
"fax_number": "801-429-8085"
}
],
"practiceLocations": [
{
"address_1": "3000 N Triumph Blvd Ste 100",
"address_purpose": "LOCATION",
"city": "Lehi",
"state": "UT",
"postal_code": "840434999",
"country_code": "US",
"telephone_number": "801-373-7351",
"fax_number": "801-429-8085",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "TOBY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-22",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "UT",
"license": "12294965-1205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00276609",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF WASHINGTON",
"identifier": "0196688",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "medreview@reverehealth.com",
"affiliation": "Y",
"affiliationName": "Central Utah Clinic, P.C.",
"address_1": "1055 N 500 W",
"city": "Provo",
"state": "UT",
"country_code": "US",
"postal_code": "846043305",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.