NPIMap

Organization Active NPI

Toledo Clinic Incorporated

  • Internal Medicine Physician
  • Monroe, MI
National Provider Identifier
1669423455
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TOLEDO CLINIC INCORPORATED
Practice address
800 Stewart Rd
Suite B
Monroe, MI 48162-4226
Phone
(734) 242-7902
NPI assigned
May 15, 2006
Last updated
Jan 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
TOLEDO CLINIC INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Authorized official

Name
Tom Sylak
Title
Chief Operating Officer
Phone
(419) 473-3561

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Clinical Medical Laboratory 291U00000X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

800 Stewart Rd
Suite B
Monroe, MI 48162-4226

Mailing address

4235 Secor Rd
Toledo, OH 43623
Phone (419) 473-3561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040617001265 MI Part B Supplier - Clinic/Group Practice 5698673382 Receives reassigned benefits from 22 practitioners
Practice locations: Lambertville, MI; Monroe, MI; Adrian, MI

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Tci Optical

Locations

777 Kimole Ln
Ste 130
Adrian, MI 49221
Phone (517) 265-0292

6525 Secor Rd
Lambertville, MI 48144
Phone (419) 479-5897

6595 Secor Rd
Lambertville, MI 48144
Phone (734) 568-6100

1084 N Monroe St
Slp Specialists
Monroe, MI 48162
Phone (734) 457-0799

2717 N Telegraph Rd
Monroe, MI 48162
Phone (734) 241-2117

4235 Secor Rd
#7
Toledo, OH 43623

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1669423455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43623",
            "telephone_number": "419-473-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 STEWART RD",
            "address_2": "SUITE B",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624226",
            "telephone_number": "734-242-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOLEDO CLINIC INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TOLEDO CLINIC INC",
        "enumeration_date": "2006-05-15",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "SYLAK",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "419-473-3561"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.