NPIMap

Individual provider Active NPI

Maxwell Eric Tolan, M.D.

  • Family Medicine Physician
  • Hazle Township, PA
National Provider Identifier
1366821274
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD462282 Issued in PA
Practice address
426 Airport Rd
Hazle Township, PA 18202-3361
Phone
(570) 459-9730
NPI assigned
May 26, 2015
Last updated
Sep 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT209727 PA
Family Medicine Physician 207Q00000X MD462282 PA Primary

Addresses

Primary practice location

426 Airport Rd
Hazle Township, PA 18202-3361

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address maxwell.tolan.2@1704.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180711002700 PA Practitioner - Family Practice 6002121571 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Caring Community Health CenterGroup PAC ID 5698004588, 46 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

426 Airport Rd
Suite 125
Hazle Township, PA 18202-3361
Phone (570) 829-2621

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Berwick Clinic Company LLC Family Medicine CurrentSince Aug 12, 2018 Accepting new patients
Caring Community Health Center CurrentSince Sep 1, 2021 Accepting new patients
Caring Community Health Center CurrentSince Sep 1, 2021 Accepting new patients

Locations

3151 Columbia Blvd
Bloomsburg, PA 17815
Phone (570) 389-7911

100 N Academy Ave
Danville, PA 17822

426 Airport Rd
Hazle Township, PA 18202
Phone (570) 453-0172

426 Airport Rd
Ste 125
Hazle Township, PA 18202
Phone (570) 829-2621

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1704/brand/1/csg/81/fhir/r4
  • Direct secure messaging: mtolan126438@direct.geisinger.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 62

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

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1366821274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 AIRPORT RD",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182023361",
            "telephone_number": "570-459-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLAN",
        "first_name": "MAXWELL",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT209727",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD462282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maxwell.tolan.2@1704.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "3151 Columbia Blvd",
            "city": "Bloomsburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178158889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hazle Township, PA

Sources for this page

Verify at the official NPI Registry.