Individual provider Active NPI

John M Tobin, PHD

  • Psychologist
  • Marshall, MI
National Provider Identifier
1265532089
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301006502 Issued in MI
Practice address
15209 W Michigan Ave
Marshall, MI 49068-9570
Phone
(269) 781-9119
Fax
(269) 789-4347
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 7

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 1

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

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ella E M Brown Charitable Circle 172 clinicians

Practice addresses (Care Compare)

15209 W Michigan Ave
Marshall, MI 49068-9570
Phone (269) 781-9119

15217 W Michigan Ave
Oaklawn Med Holistic
Marshall, MI 49068-9570
Phone (269) 789-3873

200 N Madison St
Marshall, MI 49068-1143
Phone (269) 781-4271

Hospital & facility affiliations

  • Oaklawn Hospital Hospital, Marshall, MI, CCN 230217

Merit-based Incentive Payment System (MIPS)

Final score
87.06 of 100Reported as group
Quality
85.32
Promoting interoperability
100
Improvement activities
40
Cost
71.56

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101105000411 MI Practitioner - Clinical Psychologist 3971797747 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle CurrentSince Dec 21, 2011 Accepting new patients
Ella E M Brown Charitable Circle Psychologist Current Accepting new patients
Ella E M Brown Charitable Circle Psychologist CurrentSince Dec 21, 2011 Accepting new patients

Locations

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

15209 W Michigan Ave
Marshall, MI 49068
Phone (269) 781-9119

Interoperability endpoints

  • Direct secure messaging: john.tobin.1@9698.direct.athenahealth.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301006502 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

15209 W Michigan Ave
Marshall, MI 49068-9570

Mailing address

15209 W Michigan Ave
Marshall, MI 49068-9570
Phone (269) 781-9119

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
7509107630OtherMIBCBS OF MI
P00111979OtherMIRAILROAD MEDICARE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 8, 2014.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1265532089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15209 W MICHIGAN AVE",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490689570",
            "telephone_number": "269-781-9119",
            "fax_number": "269-789-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15209 W MICHIGAN AVE",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490689570",
            "telephone_number": "269-781-9119",
            "fax_number": "269-789-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301006502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "7509107630",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00111979",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MI

Sources for this page

Verify at the official NPI Registry.