Individual provider Active NPI

Martin A. O'Toole, M.D.

  • Plastic Surgery Physician
  • Pasadena, CA
National Provider Identifier
1063504058
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G67312 Issued in CA
Practice address
542 S Fair Oaks Ave
Pasadena, CA 91105-2606
Phone
(626) 449-8910
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X G67312 CA Primary

Addresses

Primary practice location

542 S Fair Oaks Ave
Pasadena, CA 91105-2606

Mailing address

PO Box 158
La Canada, CA 91012-0158
Phone (626) 449-8910

Other identifiers 1

IdentifierTypeStateIssuer
00G673120MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040810000876 CA Practitioner - Plastic and Reconstructive Surgery 5294707261 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
67312CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
PCS Surgery Center CurrentSince Dec 30, 2020 Accepting new patients
Otoole Surgical Group Plastic Surgery CurrentSince Aug 1, 2021 Accepting new patients

Locations

1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000

542 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 449-8910

542 S Fair Oaks Ave
Fl 1
Pasadena, CA 91105
Phone (626) 449-8910

542 S Fair Oaks Ave
Fl 2
Pasadena, CA 91105
Phone (626) 449-8910

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1063504058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910120158",
            "telephone_number": "626-449-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 S FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052606",
            "telephone_number": "626-449-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'TOOLE",
        "first_name": "MARTIN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G67312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G673120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.