Active NPI
David Martone Tobolowsky, M. D.
- Psychiatry Physician
- Miami, FL
National Provider Identifier
1912904186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME35659
- Practice address
- 9601 SW 123Rd Ave
Miami, FL 33186-2540 - Phone
- (305) 667-1101
- Fax
- (786) 206-0987
- NPI assigned
- Jul 3, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Psychiatry Physician | 2084P0805X | ME35659 | FL | |
| Psychiatry Physician | 2084P0800X | ME35659 | FL | Primary |
Addresses
Primary practice location
9601 SW 123Rd Ave
Miami, FL 33186-2540
Mailing address
PO Box 165923
Miami, FL 33116-5923
Phone (305) 667-1101
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 066399900 | Medicaid | FL | |
| 95875 | Other | FL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2023 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME35659 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605052800000",
"number": "1912904186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 165923",
"city": "MIAMI",
"state": "FL",
"postal_code": "331165923",
"telephone_number": "305-667-1101",
"fax_number": "786-206-0987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9601 SW 123RD AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331862540",
"telephone_number": "305-667-1101",
"fax_number": "786-206-0987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOBOLOWSKY",
"first_name": "DAVID",
"middle_name": "MARTONE",
"name_prefix": "Dr.",
"credential": "M. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-03",
"last_updated": "2020-11-11",
"certification_date": "2020-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "FL",
"license": "ME35659",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME35659",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "066399900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "95875",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.