DR. JAMES PATRICK O'TOOLE M.D.
NPI 1790936631
Plastic Surgery in Pittsburgh, PA

Q: What is James O'toole's NPI number?

The NPI number for James O'toole is 1790936631. It was assigned to this individual provider in the NPPES registry on October 9, 2008.

Q: What is James O'toole's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Q: When was this NPI record last updated?

The NPPES record for James O'toole was last updated on November 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since October 09, 2008PECOS EnrolledAccepts Medicare Assignment

5830 ELLSWORTH AVE, SUITE 300, PITTSBURGH, PA 15232(412) 345-1615(412) 345-1613 Get Directions Write a Review

NPPES record last updated: November 21, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. James Patrick O'toole M.d. NPPES

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

DR. JAMES PATRICK O'TOOLE M.D. (NPI 1790936631) is an individual plastic surgery provider in Pittsburgh, Pennsylvania, licensed in Pennsylvania (MD421397) and active in the NPI registry since October 2008. He is enrolled in Medicare PECOS, is affiliated with Upmc Presbyterian Shadyside, and is a graduate of Saint Louis University School Of Medicine (1999).

NPPES Registry Identity

NPI1790936631

Entity TypeIndividualMale

Primary Taxonomy208200000X

Provider Legal NameDR. JAMES PATRICK O'TOOLECredential: M.D.

Location Address5830 ELLSWORTH AVE, SUITE 300Pittsburgh, PA 15232-1778

Mailing Address5830 Ellsworth Ave, Suite 300Pittsburgh, PA 15232-1778 · (412) 345-1615 · Fax (412) 345-1613

Phone(412) 345-1615

Fax(412) 345-1613

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 1999

Enumeration DateOctober 9, 2008

Last NPPES UpdateNovember 21, 2014

✔ NPI 1790936631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208200000X

License✔ Licensed in PA · MD421397

Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

5830 ELLSWORTH AVE, Pittsburgh, PA 15232

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. James Patrick O'toole 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 ID9032278684

PECOS Enrollment IDI20081111000632

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.

Areas of Expertise CMS Part B claims

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.

13 services12 patients

Hospital Affiliations CMS Care Compare

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

Upmc Presbyterian Shadyside

Acute Care Hospitals · Pittsburgh, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390164

Location200 Lothrop StreetPittsburgh, PA 15213 · Allegheny County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15232 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

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JORDAN SCOTT STASH MS, NCC, LPC

Counselor (Professional)

5830 ELLSWORTH AVE
PITTSBURGH, PA 15232

Allegheny County (412) 208-6279

SANDRA MCCOOL PT

Physical Therapist

5830 ELLSWORTH AVE, 201
PITTSBURGH, PA 15232

Allegheny County (484) 595-9300

JEFFREY FALLERONI SLP

Speech-Language Pathologist

5830 ELLSWORTH AVE, SUITE 201
PITTSBURGH, PA 15232

Allegheny County (484) 595-9300

DR. MEGAN HAMER TOMLEY LPC

Counselor (Professional)

5830 ELLSWORTH AVE
PITTSBURGH, PA 15232

Allegheny County (412) 218-2909

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 James O'toole's NPI number?

The NPI number for James O'toole is 1790936631. It was assigned to this individual provider in the NPPES registry on October 9, 2008.

Where is James O'toole located?

James O'toole practices at 5830 Ellsworth Ave Suite 300, Pittsburgh, PA 15232. The listed phone number is (412) 345-1615.

What is James O'toole's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is James O'toole enrolled in Medicare?

Yes. James 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.

Is James O'toole affiliated with any hospitals?

According to CMS data, James O'toole is affiliated with Upmc Presbyterian Shadyside.

When was this NPI record last updated?

The NPPES record for James O'toole was last updated on November 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.