Individual provider Active NPI

Rodrigo Tobar Jr., DO

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1316014566
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RT008998 Issued in MI
Practice address
29255 Northwestern Hwy
Suite 203
Southfield, MI 48034-1018
Phone
(248) 557-0535
Fax
(248) 557-6145
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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 RT008998 MI Primary

Addresses

Primary practice location

29255 Northwestern Hwy
Suite 203
Southfield, MI 48034-1018

Mailing address

29255 Northwestern Hwy
Suite 203
Southfield, MI 48034-1018
Phone (248) 557-0535

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
I20101201000375 MI Practitioner - Family Practice 5395861009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

29255 Northwestern Hwy
Suite 203
Southfield, MI 48034-5741
Phone (248) 557-0535

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RT008998MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine PC Family Medicine CurrentSince Feb 8, 1990 Accepting new patients
Spectrum Health Primary Care Partners PastSince Feb 8, 1990 Accepting new patients

Locations

29255 Northwestern Hwy
Ste 203
Southfield, MI 48034
Phone (248) 557-0535

Interoperability endpoints

  • Direct secure messaging: rodrigo.tobar.1@12099.direct.athenahealth.com
  • Direct secure messaging: rtobar1155769@direct.hfhs.org

Organizations & group practices 2

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 2

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1316014566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29255 NORTHWESTERN HWY",
            "address_2": "SUITE 203",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341018",
            "telephone_number": "248-557-0535",
            "fax_number": "248-557-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29255 NORTHWESTERN HWY",
            "address_2": "SUITE 203",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341018",
            "telephone_number": "248-557-0535",
            "fax_number": "248-557-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBAR",
        "first_name": "RODRIGO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "RT008998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.