VISHAL TOLIA DO
NPI 1316366297
Internal Medicine - Pulmonary Disease in Northport, NY
About Vishal Tolia Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VISHAL TOLIA DO (NPI 1316366297) is an individual pulmonary disease provider in Northport, New York, licensed in New York (289370) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2014).
NPPES Registry Identity
Specialties & Licenses 4
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
Vishal Tolia Do 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
3Medicare enrollment records show Vishal Tolia reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Great Neck, NY 11021
- Reassigned Medicare billing, New York enrollment
- 9,353 clinicians in this Medicare group
Corona, NY 11368
- Reassigned Medicare billing, New York enrollment
- 197 clinicians in this Medicare group
Zachary, LA 70791
- Reassigned Medicare billing, Louisiana enrollment
- 73 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11768 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
NORTHPORT, NY 11768
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 Vishal Tolia's NPI number?
The NPI number for Vishal Tolia is 1316366297. It was assigned to this individual provider in the NPPES registry on April 8, 2014.
Where is Vishal Tolia located?
Vishal Tolia practices at 79 Middleville Rd, Northport, NY 11768. The listed phone number is (631) 261-4400.
What is Vishal Tolia's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.
Is Vishal Tolia enrolled in Medicare?
Yes. Vishal Tolia 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 Vishal Tolia's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Vishal Tolia reassigns Medicare benefits to 3 organizations: North Shore-Lij Medical PC (Great Neck, NY), Urban Health Plan, Inc. (Corona, NY) and Hospital Service District 1 Of East Baton Rouge Parish (Zachary, LA). 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 Vishal Tolia's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Vishal Tolia accept?
Health plans from HMO Louisiana list Vishal Tolia 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.
When was this NPI record last updated?
The NPPES record for Vishal Tolia was last updated on April 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Vishal Tolia, DO · NPI 1316366297
Pulmonary Disease physician in Northport, New York. Individual provider, active in the CMS NPPES registry since April 8, 2014.
## Identity
- **NPI:** 1316366297 (Entity type: Individual)
- **Enumerated:** April 8, 2014
- **Primary specialty:** Internal Medicine - Pulmonary Disease · taxonomy 207RP1001X
- **State license:** 289370 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 79 MIDDLEVILLE RD, Northport, NY 11768-2200
- **Phone:** (631) 261-4400
## 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:** 3 organizations under Medicare reassignment (form CMS-855R): North Shore-Lij Medical PC (NPI 1053688572, Great Neck, NY); Urban Health Plan, Inc. (NPI 1710125141, Corona, NY); Hospital Service District 1 Of East Baton Rouge Parish (NPI 1689041824, Zachary, LA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** New York College Of Osteo Medicine Of New York Institute Of Technology, class of 2014
## Record status
- **NPPES last updated:** April 28, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1316366297) · Data from the CMS NPPES public registry.