Individual provider Active NPI

Annabelle A. Tolentino, MD.

  • Internal Medicine Physician
  • Beloit, WI
National Provider Identifier
1275566366
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
52207-020 Issued in WI
Practice address
1905 E. Huebbe Parkway
Beloit Health System Inc
Beloit, WI 53511-1842
Phone
(608) 364-2240
Fax
(608) 363-7374
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 52207-020 WI Primary
Internal Medicine Physician 207R00000X 036-083490 IL

Addresses

Primary practice location

1905 E. Huebbe Parkway
Beloit Health System Inc
Beloit, WI 53511-1842

Mailing address

1905 E. Huebbe Parkway
Beloit Health System Inc
Beloit, WI 53511-1842
Phone (608) 364-2240

Other identifiers 1

IdentifierTypeStateIssuer
1275566366MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081218000709 WI Practitioner - Internal Medicine 8123936028 Reassigns benefits to 1 organization
I20090225000589 IL Practitioner - Internal Medicine 8123936028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beloit Health System IncGroup PAC ID 8224947858, shared by 4 NPIs, 138 clinicians

Practice addresses (Care Compare)

1735 Madison Rd
Beloit, WI 53511-3216
Phone (608) 363-7510

1905 E Huebbe Pkwy
Beloit, WI 53511-1842
Phone (608) 363-5000

5601 E Rockton Rd
Roscoe, IL 61073-7601
Phone (815) 525-4800

5605 E Rockton Rd
Roscoe, IL 61073-7641
Phone (608) 364-5011

Hospital & facility affiliations

  • Commonheart Home Health Home health agency, Waukesha, WI, CCN 527151
  • Interim Healthcare of Wisconsin Home health agency, Madison, WI, CCN 527320
  • Beloit Regional Hospice Hospice, Beloit, WI, CCN 521525
  • Beloit Health System Hospital, Beloit, WI, CCN 520100
  • University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098
  • Autumn Lake Healthcare at Beloit Nursing home, Beloit, WI, CCN 525663
  • Cedar Crest Health Center Nursing home, Janesville, WI, CCN 525649

Merit-based Incentive Payment System (MIPS)

Final score
80.93 of 100Reported as group
Quality
64.82
Promoting interoperability
100
Improvement activities
40
Cost
71.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-083490ILMDInternal Medicine Physician
52207-020WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Health System Inc Internal Medicine CurrentSince Jan 1, 2010 Accepting new patients
Beloit Health System Inc Internal Medicine CurrentSince Sep 8, 2010 Accepting new patients
Beloit Clinic, S.C. Internal Medicine Current Accepting new patients
Beloit Health System, Inc CurrentSince Jan 1, 2010 Accepting new patients
Beloit Health System, Inc Past Accepting new patients

Locations

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

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
Autumn Lake Healthcare at BeloitBeloit, WI, CCN 525663 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Feb 1, 2019
Feb 1, 2019

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 7

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1275566366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E. HUEBBE PARKWAY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2240",
            "fax_number": "608-363-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 E. HUEBBE PARKWAY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2240",
            "fax_number": "608-363-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "ANNABELLE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "52207-020",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-083490",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275566366",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.