Jeffrey Tobolski, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101024035 Issued in MI

Practice address

1000 Harrington St
Mount Clemens, MI 48043-2920

Phone

(586) 493-8142

Fax

(586) 493-3250

NPI assigned

Jul 5, 2018

Last updated

Jan 23, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Emergency Medicine

Education

Michigan State University College of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Owensboro Health Medical Group IncGroup PAC ID 0648255034, 455 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Owensboro Health Regional Hospital Hospital, Owensboro, KY, CCN 180038

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Owensboro Health Medical Group Inc

  dba Owensboro Health Muhlenberg Community Hospital Wound Center

  • Surgery Physician
  • Greenville, KY
  • NPI 1235518242
  Medicare reassignment Care Compare group NPD
• Owensboro Health Medical Group Inc

  dba Owensboro Health Medical Group Premier Primary Care

  • Internal Medicine Physician
  • Owensboro, KY
  • NPI 1306700711
  NPD
• Owensboro Health Medical Group, Inc.

  dba Owensboro Health Medical Group-Emergency Medicine

  • Emergency Medicine Physician
  • Owensboro, KY
  • NPI 1285208611
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Owensboro Health Inc

  dba Owensboro Health Regional Hospital

  • General Acute Care Hospital
  • Owensboro, KY
  • NPI 1285613612
  Care Compare affiliation

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1861988586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-3727",
            "fax_number": "586-493-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-8142",
            "fax_number": "586-493-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBOLSKI",
        "first_name": "JEFFREY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-05",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101024035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie L Thompson
• Selena Tiberio, DO
• Melissa Timpa, PT
• Philip James Tims, MA LLPC
• Milissa Jean Tischbein
• Luke M Tolnai, PMHNP
• Matthew Michael Tomaszewski
• Evan Toyooka, DO
• Training & Treatment Innovations Inc
• Transition & Urgent Care Team PLLC

• Emergency Medicine Physician in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.