Individual provider Active NPI

Shane O'Toole, MD

  • Anesthesiology Physician
  • Pontiac, MI
National Provider Identifier
1114580099
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301504692 Issued in MI
Practice address
50 N Perry St
Pontiac, MI 48342-2217
Phone
(248) 338-5392
NPI assigned
Apr 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301504692 MI Primary

Addresses

Primary practice location

50 N Perry St
Pontiac, MI 48342-2217

Mailing address

50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 338-5392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230614004073 MI Practitioner - Anesthesiology 1153664552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services Associates PCGroup PAC ID 4385557602, 67 clinicians

Practice addresses (Care Compare)

1101 W University Dr
Crittenton Hospital Medical Center
Rochester, MI 48307-1863
Phone (248) 652-5000

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (586) 573-5000

2775 Blake Rd
Jackson, MI 49201-8838
Phone (517) 787-2906

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000

50 N Perry St
McLaren Oakland
Pontiac, MI 48342-2217
Phone (248) 338-5000

Hospital & facility affiliations

  • McLaren Bay Region Hospital, Bay City, MI, CCN 230041
  • McLaren Flint Hospital, Flint, MI, CCN 230141
  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • McLaren Oakland Hospital, Pontiac, MI, CCN 230207

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services Associates, PC Anesthesiology CurrentSince Jul 1, 2023 Accepting new patients

Locations

2775 Blake Rd
Jackson, MI 49201
Phone (517) 787-2906

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

432 W University Dr
Rochester, MI 48307
Phone (248) 651-6122

Organizations & group practices 1

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 5

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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1114580099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N PERRY ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422217",
            "telephone_number": "248-338-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N PERRY ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422217",
            "telephone_number": "248-338-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'TOOLE",
        "first_name": "SHANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301504692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.