Organization Active NPI

Thomas C. Tolli MD PA

  • Specialist
  • St Petersburg, FL
National Provider Identifier
1235152208
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0069472 Issued in FL
Legal business name
THOMAS C. TOLLI MD PA
Practice address
1001 37TH St N
Suite C
St Petersburg, FL 33713-6010
Phone
(727) 321-9644
Fax
(727) 327-0413
NPI assigned
Jul 25, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Thomas C Tollli, MD PA
Title
Owner
Phone
(727) 321-9644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0069472 FL Primary

Addresses

Primary practice location

1001 37TH St N
Suite C
St Petersburg, FL 33713-6010

Mailing address

1001 37TH St N
Suite C
St Petersburg, FL 33713-6010
Phone (727) 321-9644

Other identifiers 1

IdentifierTypeStateIssuer
252227600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061108000345 FL Part B Supplier - Clinic/Group Practice 2567469372 Receives reassigned benefits from 3 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFEDAD

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235152208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 37TH ST N",
            "address_2": "SUITE C",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337136010",
            "telephone_number": "727-321-9644",
            "fax_number": "727-327-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 37TH ST N",
            "address_2": "SUITE C",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337136010",
            "telephone_number": "727-321-9644",
            "fax_number": "727-327-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS C. TOLLI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TOLLLI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-321-9644",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0069472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252227600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.