Individual provider Active NPI

Evan Toyooka, DO

  • Emergency Medicine Physician
  • Mount Clemens, MI
National Provider Identifier
1508352477
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101024131 Issued in MI
Practice address
1000 Harrington St
Mount Clemens, MI 48043-2920
Phone
(586) 493-8142
Fax
(586) 493-3250
NPI assigned
Jul 3, 2018
Last updated
Apr 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 02006357A IN
Emergency Medicine Physician 207P00000X 5101024131 MI Primary

Addresses

Primary practice location

1000 Harrington St
Mount Clemens, MI 48043-2920

Mailing address

1000 Harrington St
Mount Clemens, MI 48043-2920
Phone (586) 493-3727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20230706002483 OR Practitioner - Emergency Medicine 1759630791 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.53 of 100Reported as group
Quality
96.2
Promoting interoperability
100
Improvement activities
40
Cost
84.49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2023 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2025 Accepting new patients

Locations

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Organizations & group practices 6

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 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": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1508352477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-3727",
            "fax_number": "586-493-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-8142",
            "fax_number": "586-493-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOYOOKA",
        "first_name": "EVAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02006357A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101024131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.