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ELAINE C TOZMAN M.D.
NPI 1679581235
Internal Medicine - Rheumatology in Miami, FL

Active since August 03, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1475 NW 12TH AVE, MIAMI, FL 33136(305) 243-1000 Get Directions Write a Review

NPPES record last updated: January 21, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Elaine C Tozman M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELAINE C TOZMAN M.D. (NPI 1679581235) is an individual rheumatology provider in Miami, Florida, licensed in Florida (ME41109) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and is a graduate of Other (1975).

NPPES Registry Identity

NPI1679581235
Entity TypeIndividualFemale
Primary Taxonomy207RR0500X
Provider Legal NameELAINE C TOZMANCredential: M.D.
Location Address1475 NW 12TH AVEMiami, FL 33136-1002
Mailing Address1500 Nw 12th Ave, Jmt-east 1007Miami, FL 33136-1028 · (305) 243-4664 · Fax (305) 243-9927
Phone(305) 243-1000
Sole ProprietorNo
Medical School CMSOtherGraduated 1975
Enumeration DateAugust 3, 2006
Last NPPES UpdateJanuary 21, 2014
✔ NPI 1679581235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in FL · ME41109
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
1475 NW 12TH AVE, Miami, FL 33136
Open in Google Maps ↗

Other Identifiers 3

Medicare UPIN96210FL
Medicare UPIND82250
Medicaid0678953-00FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next and more.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

Elaine C Tozman M.d. 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.

PECOS PAC ID4880870583
PECOS Enrollment IDI20110513000408
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Elaine Tozman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Miami
Same address
Radiation Oncology
1475 NW 12TH AVE, BOX 016960 M851
Miami, FL 33136
  • Reassigned Medicare billing, Florida enrollment
  • 3,639 clinicians in this Medicare group
NPI 1689624108 (305) 243-7688

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
261 services157 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
153 services116 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
39 services19 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
35 services35 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
25 services19 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jackson Health System

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100022
Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33136 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality87.16
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Appropriate Treatment for Upper Respiratory Infection (URI)
95%21 patients4/55-star benchmark: 100%
Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture
Lower rates are better for this measure.
5%99 patients
Breast Cancer Screening
33%621 patients2/55-star benchmark: 93%
Cervical Cancer Screening
19%763 patients1/55-star benchmark: 98%
Colorectal Cancer Screening
34%949 patients2/55-star benchmark: 88%
Controlling High Blood Pressure
64%339 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
44%126 patients2/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
39%126 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
93%2,767 patients4/55-star benchmark: 100%
e-Prescribing
95%1,066 patients3/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
97%441 patients4/55-star benchmark: 100%
HIV Screening
26%1,075 patients2/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
48%1,238 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
89%1,083 patients4/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
37%1,580 patients3/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 98% · 837 patients
Patients screened: 99% · 837 patients
72%29 patients3/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
100%628 patients5/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 9% · 476 patients
Patients totalRate: 24% · 476 patients
22%476 patients2/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

MS. ALISSETTE NAVEDA ARNP
Nurse Practitioner (Family)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-5360
WALTER G BRADLEY
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1475 NW 12TH AVE, BOX 016960 M851
MIAMI, FL 33136
Miami-Dade County (305) 243-7520
DR. EVAN H SCHLAM MD
Dermatology
1475 NW 12TH AVE, BOX 016960
MIAMI, FL 33136
Miami-Dade County (305) 243-7688
DR. NESTOR RICARDO VILLAMIZAR M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-2363
MS. LINDSAY MARIE THORNTON MD
Radiology (Vascular & Interventional Radiology)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-5512
DR. GLENDA C HARRIS PH.D., L.AC.
Acupuncturist
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-1470
IVAYLO MIHAYLOV
Radiology (Radiation Oncology)
1475 NW 12TH AVE, SUITE 1500
MIAMI, FL 33136
Miami-Dade County (305) 243-8223
LOURDES MESTRE VALDES APRN
Nurse Practitioner (Gerontology)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-4902

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 Elaine Tozman's NPI number?

The NPI number for Elaine Tozman is 1679581235. It was assigned to this individual provider in the NPPES registry on August 3, 2006.

Where is Elaine Tozman located?

Elaine Tozman practices at 1475 NW 12th Ave, Miami, FL 33136. The listed phone number is (305) 243-1000.

What is Elaine Tozman's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Elaine Tozman enrolled in Medicare?

Yes. Elaine Tozman 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 organization bills Medicare for Elaine Tozman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elaine Tozman reassigns Medicare benefits to University Of Miami (Miami, FL). The 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 Elaine Tozman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Elaine Tozman accept?

Health plans from Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 2 other insurers list Elaine Tozman 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 Elaine Tozman affiliated with any hospitals?

According to CMS data, Elaine Tozman is affiliated with Jackson Health System.

When was this NPI record last updated?

The NPPES record for Elaine Tozman was last updated on January 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.