Active NPI 1639260847 Individual Practitioner Male Practitioner

Dr. Derrick S Tooth , MD

Urology • Manchester, ME

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Derrick Tooth, MD is a certified Urology practicing in Manchester, ME. With approximately 35 years of clinical experience since completing medical education in 1991, Dr. Tooth delivers high-quality medical care to the local community at 1053 WESTERN AVE.

Dr. Tooth is affiliated with Mainegeneral Medical Center and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, diagnostic exam of bladder and urethra using an endoscope, new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1053 Western Ave

Manchester, ME 043513403

Telephone 2076226319

Fax 2076226654

Associated Practice Facility / Clinic

🏢 Northern New England Diagnostics Facility NPI 1013205558

Medicare Profile & Education

Medical School

Other

Graduation Year

1991

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Manchester, ME

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

35 Yrs Matches City Avg

City Avg: 35.0 Yrs

State Avg: 27.9 Yrs

Regional Practice Density

1 Specialists

Practicing in Manchester, ME (76 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

40.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Tooth (35 Years) 35 Yrs

Manchester Specialty Average (35.0 Years) 35.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	261	183	$105.08	$89.83
52000 Diagnostic exam of bladder and urethra using an endoscope	111	82	$168.24	$74.85
99213 Established patient office or other outpatient visit, typically 15 minutes	61	49	$73.64	$59.98
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	33	33	$182.73	$124.51
76872 Ultrasound scan of pelvic region through rectum	27	27	$61.56	$30.48
55700 Biopsy of prostate gland	27	27	$242.67	$119.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	198	154	$108.82	$91.67
99213 Established patient office or other outpatient visit, typically 15 minutes	121	116	$72.74	$62.50
52000 Diagnostic exam of bladder and urethra using an endoscope	92	66	$221.41	$74.55
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	34	34	$180.00	$125.37
76872 Ultrasound scan of pelvic region through rectum	19	19	$222.53	$30.79
55700 Biopsy of prostate gland	18	18	$343.78	$120.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	180	137	$108.50	$93.28
99213 Established patient office or other outpatient visit, typically 15 minutes	131	120	$73.37	$63.09
52000 Diagnostic exam of bladder and urethra using an endoscope	84	65	$296.00	$76.00
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	52	52	$180.00	$128.65
55700 Biopsy of prostate gland	18	18	$426.00	$122.72
55874 Injection of biodegradable material next to prostate	15	15	$304.00	$155.32
76872 Ultrasound scan of pelvic region through rectum	11	11	$340.00	$31.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	173	131	$107.52	$96.78
99213 Established patient office or other outpatient visit, typically 15 minutes	113	101	$72.80	$65.49
52000 Diagnostic exam of bladder and urethra using an endoscope	68	46	$296.00	$77.98
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	38	38	$218.16	$130.15
55700 Biopsy of prostate gland	20	20	$426.00	$126.65
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	20	20	$205.00	$30.67
51741 Electronic assessment of bladder emptying	15	13	$25.00	$8.37
99442 Telephone medical discussion with physician, 11-20 minutes	12	11	$118.00	$65.80

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	142	125	$110.42	$77.80
99213 Established patient office or other outpatient visit, typically 15 minutes	104	90	$72.00	$50.50
52000 Diagnostic exam of bladder and urethra using an endoscope	65	48	$296.00	$80.64
99441 Telephone medical discussion with physician, 5-10 minutes	58	58	$64.66	$25.16
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	38	38	$345.53	$127.18
99442 Telephone medical discussion with physician, 11-20 minutes	22	22	$91.59	$48.32
51741 Electronic assessment of bladder emptying	16	16	$25.00	$8.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	239	190	$114.23	$76.46
99213 Established patient office or other outpatient visit, typically 15 minutes	152	128	$73.18	$49.28
52000 Diagnostic exam of bladder and urethra using an endoscope	114	80	$306.63	$79.64
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	52	52	$346.73	$125.22
51741 Electronic assessment of bladder emptying	27	23	$28.52	$7.55
52356 Crushing of stone of ureter with insertion of stent using an endoscope	17	15	$688.00	$412.45
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	15	15	$145.00	$108.02
52332 Insertion of stent in urinary duct (ureter) using an endoscope	12	11	$308.83	$130.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	256	183	$110.20	$75.76
99213 Established patient office or other outpatient visit, typically 15 minutes	198	166	$73.29	$49.39
52000 Diagnostic exam of bladder and urethra using an endoscope	104	72	$355.37	$80.56
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	53	53	$346.79	$124.38
51741 Electronic assessment of bladder emptying	18	18	$25.00	$7.32
52332 Insertion of stent in urinary duct (ureter) using an endoscope	17	14	$612.94	$109.52
52356 Crushing of stone of ureter with insertion of stent using an endoscope	12	11	$716.67	$425.96

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	356	262	$66.87	$48.98
52000 Diagnostic exam of bladder and urethra using an endoscope	119	93	$404.07	$98.23
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	118	92	$104.18	$75.49
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	40	40	$207.75	$122.79
51741 Electronic assessment of bladder emptying	27	26	$25.00	$7.30
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	24	24	$109.75	$73.21
52224 Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope	17	14	$1289.00	$199.67

Medical Specialties & State Licenses

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License ME 014663

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

255890099 (ME)

Commercial Insurance / Payer ID Anthem

030440 (ME)

Commercial Insurance / Payer ID Aetna

1041053

Hospital & Practice Group Affiliations

Mainegeneral Medical Center

442 Civic Ctr Dr, Augusta, ME 043308572

Phone: 2076244800

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners

Dr. Ali Jardaneh , MD

Urology

NPI 1073177325

Doctor of Medicine (M.D.)

Margo Taylor , FNP

Nurse Practitioner - Family

NPI 1265086581

Family Nurse Practitioner

Meagan Grant

Nurse Practitioner

NPI 1306454111

Heather Smith , NP

Nurse Practitioner - Gerontology

NPI 1356042642

Nurse Practitioner

Dr. Otto Sandoval Linares , MD

Urology

NPI 1407010598

Doctor of Medicine (M.D.)

Shawn Mcglew , PA-C

Physician Assistant

NPI 1417918665

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active December 05, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location December 05, 2012

Registered at 1053 WESTERN AVE, MANCHESTER, ME 043513403 (Tel: 2076226319)

📍

Updated Business Mailing Address December 05, 2012

Registered at 9 PLEASANT STREET, SUITE 2, OAKLAND, ME 04963 (Tel: 2074652700)

👤

Provider Name / Credentials Updated December 05, 2012

Recorded as DERRICK TOOTH, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 05, 2012

Urology (License #014663 in ME)

🟢

Initial NPI Registration & Enumeration September 27, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1639260847

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 27, 2006

Last Update: December 05, 2012

Sole Proprietor: No

Update or Correct Profile

Mailing Address

9 Pleasant Street, Suite 2

Oakland, ME 04963

Phone: 2074652700

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.