Individual provider Active NPI

Jill Tolia, M.D.

  • Infectious Disease Physician
  • Leesburg, FL
National Provider Identifier
1972721629
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME153272 Issued in FL
Practice address
410 Fern Dr
Leesburg, FL 34748-7008
Phone
(352) 218-8200
Fax
(352) 435-0690
NPI assigned
Apr 20, 2007
Last updated
May 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X ME153272 FL Primary

Addresses

Primary practice location

410 Fern Dr
Leesburg, FL 34748-7008

Mailing address

9301 Summit Centre Way Unit 3212
Orlando, FL 32810-6329
Phone (973) 615-4974

Other identifiers 1

IdentifierTypeStateIssuer
112324100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20211020001633 FL Practitioner - Infectious Disease 6406935782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeview Healthcare System, LLCGroup PAC ID 8921074733, 25 clinicians

Practice addresses (Care Compare)

410 Fern Dr
Leesburg, FL 34748-7008
Phone (352) 812-8200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME153272FLMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Healthcare System, LLC CurrentSince Nov 1, 2021 Accepting new patients
Openloop Healthcare Partners PC CurrentSince Dec 1, 2023 Accepting new patients
Lakeview Healthcare System, LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

410 Fern Dr
Leesburg, FL 34748
Phone (352) 218-8200

18550 US Highway 441
Mount Dora, FL 32757
Phone (352) 735-3755

10250 SE 167th Place Rd
Unit 5
Summerfield, FL 34491
Phone (352) 307-9225

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jtolia565887@direct.shands.ufl.edu
  • Direct secure messaging: jtolia61806@epicdirect.rwjbh.org
  • Direct secure messaging: jtolia192030@directvirtua.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1972721629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 SUMMIT CENTRE WAY UNIT 3212",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328106329",
            "telephone_number": "973-615-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 FERN DR",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487008",
            "telephone_number": "352-218-8200",
            "fax_number": "352-435-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLIA",
        "first_name": "JILL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME153272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112324100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.