NPIMap

Individual provider Active NPI

Petra Toutanji, MD

  • Family Medicine Physician
  • Portage, MI
National Provider Identifier
1720298359
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301108869 Issued in MI
Practice address
3300 W Centre Ave
Portage, MI 49024-4666
Phone
(269) 324-8950
Fax
(269) 324-2134
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 28476 AL
Family Medicine Physician 207Q00000X 4301108869 MI Primary

Addresses

Primary practice location

3300 W Centre Ave
Portage, MI 49024-4666

Mailing address

3300 W Centre Ave
Portage, MI 49024-4666
Phone (269) 324-8950

Other identifiers 1

IdentifierTypeStateIssuer
1720298359OtherALNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160223001569 MI Practitioner - Family Practice 3577646223 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ella E M Brown Charitable CircleGroup PAC ID 1254228745, 172 clinicians

Practice addresses (Care Compare)

200 N Madison St
Marshall, MI 49068-1143
Phone (269) 781-4271

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

Merit-based Incentive Payment System (MIPS)

Final score
87.06 of 100Reported as group
Quality
85.32
Promoting interoperability
100
Improvement activities
40
Cost
71.56

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle CurrentSince Jun 1, 2023 Accepting new patients
Ella E M Brown Charitable Circle Family Medicine CurrentSince Jun 1, 2023 Accepting new patients
Bronson Methodist Hospital CurrentSince Jan 23, 2017 Accepting new patients
American Family Care, LLC Past Accepting new patients
Crestwood Physician Services, LLC Family Medicine PastSince Mar 1, 2018 Accepting new patients
Ella E M Brown Charitable Circle Past Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

14231 Beadle Lake Rd
Battle Creek, MI 49014
Phone (269) 704-5180

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

3300 W Centre Ave
Portage, MI 49024
Phone (269) 324-8950

Interoperability endpoints

  • Direct secure messaging: ptoutanji84690@direct.bronsonhg.org
  • Direct secure messaging: direct@direct.bronsonhg.org
  • Direct secure messaging: petra.toutanji.1@9698.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3038/brand/1/csg/64/fhir/r4

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 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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1720298359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244666",
            "telephone_number": "269-324-8950",
            "fax_number": "269-324-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244666",
            "telephone_number": "269-324-8950",
            "fax_number": "269-324-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOUTANJI",
        "first_name": "PETRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "28476",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301108869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720298359",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.