NPIMap

Individual provider Active NPI

Azra Abbasi, AGNP-C

  • Gerontology Nurse Practitioner
  • Okemos, MI
National Provider Identifier
1871196014
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704287117 Issued in MI
Practice address
2205 Jolly Rd Ste B
Okemos, MI 48864-3983
Phone
(517) 347-4085
NPI assigned
Nov 19, 2020
Last updated
Jul 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704287117 MI
Gerontology Nurse Practitioner 363LG0600X 4704287117 MI Primary

Addresses

Primary practice location

2205 Jolly Rd Ste B
Okemos, MI 48864-3983

Mailing address

PO Box 40412
Belfast, ME 04915-1255
Phone (248) 824-6500

Other practice location 1

190 Lake Ridge Dr
Mason, MI 48854-8328
Phone (517) 833-0522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210409000412 MI Practitioner - Nurse Practitioner 5395153423 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vpa PCGroup PAC ID 9234041948, 181 clinicians

Practice addresses (Care Compare)

Okemos, MI 48864
Phone (517) 347-4085

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704287117MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Jul 1, 2025 Accepting new patients
Vpa PC CurrentSince Jul 1, 2025 Accepting new patients
Vpa PC Current Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Sep 1, 2025 Accepting new patients

Locations

2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 999-0138

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: aabbasi@landmarkhealth-direct.org

Organizations & group practices 4

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 8

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": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1871196014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40412",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049151255",
            "telephone_number": "248-824-6500",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 JOLLY RD STE B",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643983",
            "telephone_number": "517-347-4085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 Lake Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Mason",
            "state": "MI",
            "postal_code": "488548328",
            "country_code": "US",
            "telephone_number": "517-833-0522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABBASI",
        "first_name": "AZRA",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704287117",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704287117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.