SEAN MICHAEL O TOOLE MD
NPI 1306578695
Hospitalist in Augusta, GA
About Sean Michael O Toole Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SEAN MICHAEL O TOOLE MD (NPI 1306578695) is an individual hospitalist provider in Augusta, Georgia, licensed in Texas (W4396) and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS, is affiliated with Au Medical Center, and maintains a secondary practice location in San Antonio.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Sean Michael O Toole Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Sean O Toole reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Roswell, GA 30076
- Reassigned Medicare billing, Georgia enrollment
- 3,885 clinicians in this Medicare group
San Antonio, TX 78207
- Reassigned Medicare billing, Texas enrollment
- 1,129 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Au Medical Center
Acute Care Hospitals · Augusta, GAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30912 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
AUGUSTA, GA 30912
AUGUSTA, GA 30912
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Sean O Toole's NPI number?
The NPI number for Sean O Toole is 1306578695. It was assigned to this individual provider in the NPPES registry on June 27, 2022.
Where is Sean O Toole located?
Sean O Toole practices at 1120 15th St # Bi5070, Augusta, GA 30912. The listed phone number is (706) 721-2423.
What is Sean O Toole's specialty?
The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.
Is Sean O Toole enrolled in Medicare?
Yes. Sean O Toole is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Sean O Toole's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sean O Toole reassigns Medicare benefits to 2 organizations: Wellstar Medical Group, LLC (Roswell, GA) and Community Medicine Associates (San Antonio, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sean O Toole's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Sean O Toole accept?
Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 4 other insurers list Sean O Toole as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Sean O Toole affiliated with any hospitals?
According to CMS data, Sean O Toole is affiliated with Au Medical Center.
When was this NPI record last updated?
The NPPES record for Sean O Toole was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Sean Michael O Toole, MD · NPI 1306578695
Hospitalist physician in Augusta, Georgia. Individual provider, active in the CMS NPPES registry since June 27, 2022.
## Identity
- **NPI:** 1306578695 (Entity type: Individual)
- **Enumerated:** June 27, 2022
- **Primary specialty:** Hospitalist · taxonomy 208M00000X
- **State license:** W4396 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 1120 15TH ST # BI5070, Augusta, GA 30912-0004
- **Phone:** (706) 721-2423
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Wellstar Medical Group, LLC (NPI 1922405729, Roswell, GA); Community Medicine Associates (NPI 1245313329, San Antonio, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Medical College Of Wisconsin, class of 2022
## Record status
- **NPPES last updated:** July 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1306578695) · Data from the CMS NPPES public registry.