Individual provider Active NPI

Farouk S Tootla, M.D.

  • Colon & Rectal Surgery Physician
  • Bloomfield Hills, MI
National Provider Identifier
1568569655
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
37393 Issued in MI
Practice address
44060 Woodward Ave
Bloomfield Hills, MI 48302-5038
Phone
(248) 334-3197
Fax
(248) 335-8857
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 37393 MI Primary

Addresses

Primary practice location

44060 Woodward Ave
Bloomfield Hills, MI 48302-5038

Mailing address

44060 Woodward Ave
Bloomfield Hills, MI 48302-5038
Phone (248) 334-3197

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
I20110210000748 MI Practitioner - Colorectal Surgery (Proctology) 5092733170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5220 Highland Rd
Suite 200
Waterford, MI 48327-1973
Phone (248) 334-3197

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy23
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37393MIMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tootla and Associates MD PC Colon & Rectal Surgery CurrentSince Feb 1, 2011 Accepting new patients
Safiul Hasan M.D. PC CurrentSince Feb 1, 2011 Accepting new patients
North Oakland ASC LLC PastSince Apr 30, 2003 Accepting new patients

Locations

44060 Woodward Ave
Ste 104
Bloomfld Hls, MI 48302
Phone (248) 334-3197

5220 Highland Rd
Ste 200
Waterford, MI 48327
Phone (248) 334-3197

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568569655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44060 WOODWARD AVE",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025038",
            "telephone_number": "248-334-3197",
            "fax_number": "248-335-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44060 WOODWARD AVE",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025038",
            "telephone_number": "248-334-3197",
            "fax_number": "248-335-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOOTLA",
        "first_name": "FAROUK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MI",
            "license": "37393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.