Individual provider Active NPI

Michael E Tofano, M.D.

  • Internal Medicine Physician
  • Worcester, MA
National Provider Identifier
1770773814
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
163045-1 Issued in NY
Practice address
119 Belmont St
Hospital Medicine
Worcester, MA 01605-2903
Phone
(508) 334-8515
Fax
(508) 334-6490
NPI assigned
Jul 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 163045-1 NY Primary

Addresses

Primary practice location

119 Belmont St
Hospital Medicine
Worcester, MA 01605-2903

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other identifiers 1

IdentifierTypeStateIssuer
2146355MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121218000387 NY Practitioner - HospitalistPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2668405168 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
163045-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John T Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital CurrentSince Oct 1, 2012 Accepting new patients
John T Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital CurrentSince Oct 1, 2012 Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients

Locations

100 Highlands Blvd
#9
Port Jefferson, NY 11777
Phone (631) 686-7809

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

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.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1770773814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BELMONT ST",
            "address_2": "HOSPITAL MEDICINE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052903",
            "telephone_number": "508-334-8515",
            "fax_number": "508-334-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOFANO",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "163045-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2146355",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.