Individual provider Active NPI

Karen A Tosiello, PA-C

  • Surgical Physician Assistant
  • Traverse City, MI
National Provider Identifier
1407898810
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601001884 Issued in MI
Practice address
4110 Copper Ridge Dr
Suite 242
Traverse City, MI 49684-7255
Phone
(231) 929-7700
NPI assigned
Jun 11, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5601001884 MI Primary

Addresses

Primary practice location

4110 Copper Ridge Dr
Suite 242
Traverse City, MI 49684-7255

Mailing address

4110 Copper Ridge Dr
Ste 242
Traverse City, MI 49684-6721
Phone (231) 943-9083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601001884MIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services Past Accepting new patients
Pine Rest Christian Mental Health Services Past Accepting new patients
Munson Medical Group Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407898810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 COPPER RIDGE DR",
            "address_2": "STE 242",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846721",
            "telephone_number": "231-943-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 COPPER RIDGE DR",
            "address_2": "SUITE 242",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847255",
            "telephone_number": "231-929-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOSIELLO",
        "first_name": "KAREN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601001884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.