Brian J Tollefson, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

18987 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-5571

Fax

(601) 984-5583

NPI assigned

Jul 6, 2006

Last updated

Mar 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Emergency Medicine

Education

University of Minnesota Medical School, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of Mississippi - University of Mississippi Medical CenterGroup PAC ID 1850293036, 956 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001

Merit-based Incentive Payment System (MIPS)

Final score

83.94 of 100Reported as group

Quality

67.75

Promoting interoperability

100

Improvement activities

40

Cost

71.17

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• LA PPO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment Care Compare group NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• Chickasaw Emergency Group LLC

  • Medical Physician Assistant
  • Houston, MS
  • NPI 1134215478

  Emergency Medicine

  NPD (past)
• Lefleur Emergency Physicians

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1891985420
  NPD (past)
• Marion General Hospital

  • Rural Acute Care Hospital
  • Columbia, MS
  • NPI 1083637904
  NPD (past)
• Southern Health Corp. of Houston, Inc

  dba Family Medical Clinic of Houston

  • Rural Health Clinic/Center
  • Houston, MS
  • NPI 1083721732
  NPD (past)
• Sterling Emergency Services of Mississippi, Inc

  • Nurse Practitioner
  • Jackson, MS
  • NPI 1932167533

  Emergency Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Care Compare affiliation

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1093747776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CLINTON CENTER DRIVE",
            "address_2": "CBO SUITE 4300",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564500",
            "telephone_number": "601-815-2005",
            "fax_number": "601-984-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5571",
            "fax_number": "601-984-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLEFSON",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "18987",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MS",
            "license": "18987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD NUMBER",
            "identifier": "P00772006",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN EFFECTIVE 7/17/09",
            "identifier": "512I930490",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178297",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1796778",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bernice Y Tolbert
• Charles Culley Tolbert, DMD
• Kenneth P Toler Jr., M.D.
• Noel K. Toler Jr., D.D.S., P.A.
• Noel K. Toler III, D.M.D.
• Barbara Ann Tolleson, CFNP
• Maharaj Alejandro Tomar, MD
• Emily Tomey
• Courtney Wages Tomlinson, CFNP
• Gabriel William Tonkin, M.D.

• Sports Medicine (Family Medicine) Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Sports Medicine (Family Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.

Verify at the official NPI Registry.