Dr James Patrick O'toole, MD - Medicare Plastic And Reconstructive Surgery in Pittsburgh, PA

Dr James Patrick O'toole, MD is a medicare enrolled "Plastic Surgery" physician in Pittsburgh, Pennsylvania. He went to Saint Louis University School Of Medicine and graduated in 1999 and has 25 years of diverse experience with area of expertise as Plastic And Reconstructive Surgery. He is a member of the group practice O'toole Plastic Surgery, Pc and his current practice location is 5830 Ellsworth Ave, Suite 300, Pittsburgh, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (412) 345-1615.

Dr James Patrick O'toole is licensed to practice in Pennsylvania (license number MD421397) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1790936631.

Contact Information

Dr James Patrick O'toole, MD
5830 Ellsworth Ave, Suite 300,
Pittsburgh, PA 15232-1778
(412) 345-1615
(412) 345-1613

Map and Direction




Physician's Profile

Full NameDr James Patrick O'toole
GenderMale
SpecialityPlastic And Reconstructive Surgery
Experience25 Years
Location5830 Ellsworth Ave, Pittsburgh, Pennsylvania
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr James Patrick O'toole attended and graduated from Saint Louis University School Of Medicine in 1999
  NPI Data:
  • NPI Number: 1790936631
  • Provider Enumeration Date: 10/09/2008
  • Last Update Date: 11/21/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 9032278684
  • Enrollment ID: I20081111000632

Medical Identifiers

Medical identifiers for Dr James Patrick O'toole such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1790936631NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208200000XPlastic Surgery MD421397 (Pennsylvania)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Upmc Presbyterian ShadysidePittsburgh, PAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
O'toole Plastic Surgery, Pc37797241582

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr James Patrick O'toole allows following entities to bill medicare on his behalf.
Entity NameO'toole Plastic Surgery, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760725139
PECOS PAC ID: 3779724158
Enrollment ID: O20130727000030

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr James Patrick O'toole is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr James Patrick O'toole, MD
5830 Ellsworth Ave, Suite 300,
Pittsburgh, PA 15232-1778

Ph: (412) 345-1615
Dr James Patrick O'toole, MD
5830 Ellsworth Ave, Suite 300,
Pittsburgh, PA 15232-1778

Ph: (412) 345-1615

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.