Active NPI
Yasmin Farouk Tootla, M.D.
- Trauma Surgery Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Trauma Surgery Physician
- License
- 036147564
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (313) 916-1601
- NPI assigned
- Jun 1, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | L2014754 | MI | |
| Trauma Surgery Physician | 2086S0127X | 036147564 | IL | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2608
Other practice location 1
305 W Jackson St Ste 206
Carbondale, IL 62901-1474
Phone (618) 457-3006
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 214881 | Other | IL | MULTI SPECIALTY GROUP PTAN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ytootla28226@sih.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1775 Dempster St
Park Ridge, IL 60068-1143
214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160
4440 W 95TH St
Oak Lawn, IL 60453-2600
Hospital & facility affiliations
- Advocate Christ Hospital & Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 14 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L2014754 | MI | MD | Surgery Physician |
| 036147564 | IL | MD | Trauma Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emory Medical Care Foundation Inc | Surgery | Current | Accepting new patients |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Emory Medical Care Foundation Inc | Current | Accepting new patients | |
| Southern Illinois Medical Services, NFP | Current | Accepting new patients | |
| Southern Illinois Medical Services, NFP | Past | Accepting new patients |
Locations
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370
101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
305 W Jackson St
Ste 206
Carbondale, IL 62901
Phone (618) 457-3006
2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300
28592 Network Pl
Chicago, IL 60673
29373 Network Pl
Chicago, IL 60673
4220 W 95th St
Ste 200
Oak Lawn, IL 60453
Phone (708) 398-0287
4440 W 95th St
Ste Aip
Oak Lawn, IL 60453
Phone (708) 684-8000
1775 Dempster St
Ste Aip
Park Ridge, IL 60068
Phone (708) 283-5500
Interoperability endpoints
- ytootla217707@direct.myadvocateaurora.org
- ytootla28226@sih.direct-ci.com
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.
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
-
- Diagnostic Radiology Physician
- Atlanta, GA
- NPI 1225294739
-
- Rural Health Clinic/Center
- Carbondale, IL
- NPI 1154510808
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- General Acute Care Hospital
- Oak Lawn, IL
- NPI 1548375082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610064000000",
"number": "1447544903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "313-916-1601"
}
],
"practiceLocations": [
{
"address_1": "305 W Jackson St Ste 206",
"address_purpose": "LOCATION",
"city": "Carbondale",
"state": "IL",
"postal_code": "629011474",
"country_code": "US",
"telephone_number": "618-457-3006",
"fax_number": "618-457-3008",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TOOTLA",
"first_name": "YASMIN",
"middle_name": "FAROUK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-01",
"last_updated": "2021-01-08",
"certification_date": "2021-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "L2014754",
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "IL",
"license": "036147564",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTI SPECIALTY GROUP PTAN",
"identifier": "214881",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ytootla28226@sih.direct-ci.com",
"affiliation": "N",
"address_1": "305 W Jackson St Ste 206",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629011474",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.