DR. AMANDA J TOOLE MD
NPI 1982796488
Otolaryngology - Plastic Surgery within the Head & Neck in Saint Clair Shores, MI
NPI Status: Active since September 29, 2006
Contact Information
21000 E 12 MILE RD
SUITE 111
SAINT CLAIR SHORES, MI
ZIP 48081
Phone: (586) 779-7610
Fax: (586) 445-2523
- Individual
- Female
- Otolaryngology
- Plastic Surgery within the Head & Neck
- PECOS Enrolled
- Medicare Quality Reporting
About AMANDA TOOLE
This page provides the complete NPI Profile along with additional information for Amanda Toole, a provider established in Saint Clair Shores, Michigan with a medical specialization in Otolaryngology, focusing in plastic surgery within the head & neck . The healthcare provider is registered in the NPI registry with number 1982796488 assigned on September 2006. The practitioner's primary taxonomy code is 207YX0007X with license number AT077352 (MI). The provider is registered as an individual and her NPI record was last updated 19 years ago.
- NPI
- 1982796488
- Provider Name
- DR. AMANDA J TOOLE MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 21000 E 12 MILE RD SUITE 111 SAINT CLAIR SHORES, MI 48081
- Location Phone
- (586) 779-7610
- Location Fax
- (586) 445-2523
- Mailing Address
- 21000 E 12 MILE RD STE 111 ST CLAIR SHORES, MI 48081
- Mailing Phone
- (586) 226-4301
- Mailing Fax
- (586) 445-2523
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-29-2006
- Last Update Date
- 10-05-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Otolaryngology Plastic Surgery within the Head & Neck
- Taxonomy Code
- 207YX0007X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- AT077352
- License State
- MI
- Taxonomy Description
- An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0501109 | OTHER (01) | BLUE CARE NETWORK | |
| C7547 | OTHER (01) | MCAR | |
| 4112028002 | OTHER (01) | CIGNA | |
| 05041561041 | MEDICARE ID-TYPE UNSPECIFIED (04) | MI | |
| 131198 | OTHER (01) | CARE CHOICES | |
| 0405011091 | OTHER (01) | BLUE CROSS BLUE SHIELD | |
| H31309 | OTHER (01) | HEALTH ALLIANCE PLAN | |
| 7246248 | OTHER (01) | AETNA | |
| 4284574 | MEDICAID (05) | MI | |
| 104263 | OTHER (01) | GREAT LAKES | |
| H31309 | MEDICARE UPIN (02) | MI |
Medicare Participation & PECOS Enrollment Status
Amanda Toole is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Breast Cancer Screening | 36% | 592 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Colorectal Cancer Screening | 32% | 977 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| e-Prescribing | 99% | 475 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 75% | 150 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Medication Reconciliation | 100% | 996 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 53% | 1827 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Provide Patient Access | 76% | 1827 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 29% | 1827 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
Reviews for DR. AMANDA J TOOLE MD
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1982796488, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 72 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SAINT CLAIR SHORES, MI 48081
SAINT CLAIR SHORES, MI 48081
SAINT CLAIR SHORES, MI 48081
SAINT CLAIR SHORES, MI 48081
SAINT CLAIR SHORES, MI 48081
SAINT CLAIR SHORES, MI 48081
SAINT CLAIR SHORES, MI 48081
SAINT CLAIR SHORES, MI 48081
SAINT CLAIR SHORES, MI 48081
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1982796488, enumerated as an "individual" on September 29, 2006.
The provider is located at 21000 E 12 MILE RD SUITE 111 SAINT CLAIR SHORES, MI 48081 and the phone number is (586) 779-7610.
Otolaryngology with taxonomy code 207YX0007X and a focus in Plastic Surgery within the Head & Neck.
The provider might be accepting Accepts: Medicare, Medicaid, Cigna, Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.
