NPIMap

Individual provider Active NPI

Tolga Icli, MD

  • Family Medicine Physician
  • Austintown, OH
National Provider Identifier
1114182979
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35 097338 Issued in OH
Practice address
1450 S Canfield Niles Rd
Austintown, OH 44515-4085
Phone
(330) 799-8752
Fax
(330) 799-8754
NPI assigned
Jul 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35 097338 OH Primary

Addresses

Primary practice location

1450 S Canfield Niles Rd
Austintown, OH 44515-4085

Mailing address

1450 S Canfield Niles Rd
Austintown, OH 44515-4085
Phone (330) 799-8752

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120201001007 OH Practitioner - Family Practice 6709043763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35 097338OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Jan 15, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Jul 1, 2018 Accepting new patients
Steward Medical Group Inc. Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Omni Manor, Inc. Past Accepting new patients
Youngstown Area Jewish Federation Past Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

1350 E Market St
Warren, OH 44483
Phone (330) 841-5969

500 Gypsy Ln
Youngstown, OH 44504
Phone (330) 740-4572

1450 S Canfield Niles Rd
Youngstown, OH 44515
Phone (330) 270-2700

5170 Belmont Ave
Youngstown, OH 44505
Phone (330) 759-1080

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Canfield Acres Company LLC Dba Windsor House at CanfieldCanfield, OH, CCN 366460 Skilled nursing facility Adp of the SNF Sep 14, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1114182979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 S CANFIELD NILES RD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445154085",
            "telephone_number": "330-799-8752",
            "fax_number": "330-799-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 S CANFIELD NILES RD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445154085",
            "telephone_number": "330-799-8752",
            "fax_number": "330-799-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICLI",
        "first_name": "TOLGA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35 097338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austintown, OH

Sources for this page

Verify at the official NPI Registry.