Amod S Tootla, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

4301031237 Issued in MI

Practice address

5220 Highland Rd Ste 200
Waterford, MI 48327-1973

Phone

(248) 334-3197

Fax

(248) 335-8857

NPI assigned

Jan 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Safiul Hasan M.D. PC

  • Specialist
  • Waterford, MI
  • NPI 1689860769
  NPD
• Tootla and Associates MD PC

  • Colon & Rectal Surgery Physician
  • Bloomfield Hills, MI
  • NPI 1528235538
  NPD
• Devinderjit S Bhangu, MD PLLC

  • Medical Specialty Clinic/Center
  • Grand Blanc, MI
  • NPI 1225204399
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1841340510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 HIGHLAND RD STE 200",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271973",
            "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": "5220 HIGHLAND RD STE 200",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271973",
            "telephone_number": "248-334-3197",
            "fax_number": "248-335-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOOTLA",
        "first_name": "AMOD",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "AT031237",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MI",
            "license": "4301031237",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301031237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2100453",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0639891",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Alessandra Scalisi Tischendorf, DDS
• TLC Soulutions, Inc.
• Todays Smiles
• Ashley Jamilia Toman
• Danielle Toney, LLBSW
• Jordyn A Topping, NP-C
• Angelita Renee Torres
• Lesley Nicole Toto, LLMSW, SSW
• Timothy Tout II
• Aria Gillian Savannah Trager, DO

• Specialist in Waterford, MI
• Providers in Waterford, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.