Individual provider Active NPI

Michael Lawrence Tobin, M.D

  • Cardiovascular Disease Physician
  • Broomall, PA
National Provider Identifier
1629211644
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD446636 Issued in PA
Practice address
1999 Sproul Rd Ste 25
Broomall, PA 19008-3508
Phone
(610) 353-6400
Fax
(610) 356-1836
NPI assigned
Apr 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD446636 PA Primary

Addresses

Primary practice location

1999 Sproul Rd Ste 25
Broomall, PA 19008-3508

Mailing address

1999 Sproul Rd Ste 25
Broomall, PA 19008-3508
Phone (610) 353-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160708000344 PA Practitioner - Cardiovascular Disease (Cardiology) 2668604307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1999 Sproul Rd
Broomall, PA 19008-3508
Phone (610) 353-6400

Hospital & facility affiliations

  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Jun 1, 2021 Accepting new patients

Locations

1999 Sproul Rd
Ste 25
Broomall, PA 19008
Phone (610) 353-6400

1991 Sproul Rd
Ste 220
Broomall, PA 19008
Phone (610) 353-6400

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

Interoperability endpoints

  • Direct secure messaging: mtobin@mma.gwaydirect.com

Organizations & group practices 1

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 5

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": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1629211644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 SPROUL RD STE 25",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083508",
            "telephone_number": "610-353-6400",
            "fax_number": "610-356-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 SPROUL RD STE 25",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083508",
            "telephone_number": "610-353-6400",
            "fax_number": "610-356-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "MICHAEL",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-07",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD446636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

Verify at the official NPI Registry.