JIHAN TOOTLA – Acute Care Nurse Practitioner, NPI 1396539805

JIHAN TOOTLA is a healthcare provider. based in Detroit, Michigan. specializing in NURSE PRACTITIONER. They hold a License No. 4704280195 (MI). The NPI Number for JIHAN TOOTLA is 1396539805

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
JIHAN TOOTLA
NPI
1396539805
Phone
(313) 745-8040
Address
3990 JOHN R ST
Enumeration Date
8 April 2025
Last Update Date
4 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3137458040
Graduation Year
2024 (2 years ago)
PAC ID
5294242525
Group Practice PAC ID
8921289760
Professional Enrollment ID
I20250730001853
Address ID
MI482012018DE3990XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness75
Years active:1State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

Provider Addresses for JIHAN TOOTLA

  • 3990 JOHN R ST

    DETROIT, MI 482012097

    Phone: (313) 745-8040

    Type: Location

  • 5935 HUMMINGBIRD LN

    CLARKSTON, MI 483462934

    Phone: (248) 470-2971

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250730001853INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48201)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921289760View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YMI
-MI
Nurse PractitionerMI
Physician AssistantMI
Clinical PsychologistMI
Physician AssistantMI
-MI
Diagnostic RadiologyMI
Vascular Surgery, General SurgeryMI
Orthopedic SurgeryMI

Reviews

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Frequently asked questions

Is JIHAN TOOTLA listed with a National Provider Identifier?
Yes — JIHAN TOOTLA has NPI 1396539805 on file in the registry.
Active or inactive — what applies to JIHAN TOOTLA?
You should see JIHAN TOOTLA as active in CMS-hosted NPPES data.
What area of care is associated with JIHAN TOOTLA?
JIHAN TOOTLA's record emphasizes Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JIHAN TOOTLA?
Travel planning: use Detroit, Michigan as the reference point for JIHAN TOOTLA, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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