NPIMap

Individual provider Active NPI

Azam Tolla, DO

  • Neurology Physician
  • Toledo, OH
National Provider Identifier
1487148003
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
34.018118 Issued in OH
Practice address
3949 Sunforest CT Ste 105
Toledo, OH 43623-4454
Phone
(419) 475-9341
Fax
(419) 474-0095
NPI assigned
Jun 18, 2018
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 5101024166 MI
Neurology Physician 2084N0400X 34.018118 OH Primary

Addresses

Primary practice location

3949 Sunforest CT Ste 105
Toledo, OH 43623-4454

Mailing address

3949 Sunforest CT Ste 105
Toledo, OH 43623-4454

Other practice location 1

3851 Navarre Ave Ste 250
Oregon, OH 43616-3672
Phone (419) 475-9341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250807000831 OH Practitioner - Nephrology 2062760036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3949 Sunforest CT
Toledo, OH 43623-4473
Phone (419) 475-9341

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.018118OHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Jul 31, 2025 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Jul 31, 2025 Accepting new patients
Mercy Health - St Vincent Medical Center LLC Past Accepting new patients

Locations

3851 Navarre Ave
Ste 250
Oregon, OH 43616
Phone (419) 251-8019

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

3949 Sunforest Ct
Toledo, OH 43623
Phone (419) 474-3399

3949 Sunforest Ct
Ste 105
Toledo, OH 43623
Phone (419) 475-8809

Interoperability endpoints

  • Direct secure messaging: atolla1858760@direct.bsmhealth.org

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1487148003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 SUNFOREST CT STE 105",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 SUNFOREST CT STE 105",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234454",
            "telephone_number": "419-475-9341",
            "fax_number": "419-474-0095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3851 Navarre Ave Ste 250",
            "address_purpose": "LOCATION",
            "city": "Oregon",
            "state": "OH",
            "postal_code": "436163672",
            "country_code": "US",
            "telephone_number": "419-475-9341",
            "fax_number": "419-474-0095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLLA",
        "first_name": "AZAM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "5101024166",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "34.018118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.