Individual provider Active NPI

Azra Marie Totobesola

  • Nurse Practitioner
  • Saint Joseph, MI
National Provider Identifier
1871334623
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704311055 Issued in MI
Practice address
4025 Health Park LN
Saint Joseph, MI 49085-3421
Phone
(269) 985-4467
Fax
(269) 429-5606
NPI assigned
Jun 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704311055 MI
Nurse Practitioner 363L00000X 4704311055 MI Primary

Addresses

Primary practice location

4025 Health Park LN
Saint Joseph, MI 49085-3421

Mailing address

4025 Health Park LN
Saint Joseph, MI 49085-3421
Phone (269) 985-4467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250508000425 MI Practitioner - Nurse Practitioner 9830616317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospice at Home, Inc.Group PAC ID 9537178116, 10 clinicians

Practice addresses (Care Compare)

400 Medical Park Dr
Watervliet, MI 49098-9225
Phone (269) 463-3600

4025 Health Park LN
Saint Joseph, MI 49085-3421
Phone (269) 429-7100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Community Hospital Watervliet CurrentSince Aug 18, 2025 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Aug 18, 2025 Accepting new patients
Hospice at Home, Inc. CurrentSince Feb 27, 2025 Accepting new patients
Lakeland Community Hospital Watervliet Current Accepting new patients

Locations

4025 Health Park Ln
Saint Joseph, MI 49085
Phone (269) 429-7100

400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111

Interoperability endpoints

  • Direct secure messaging: atotobesola1272360@epic00.corewelldirect.org
  • FHIR API: https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1871334623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 HEALTH PARK LN",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853421",
            "telephone_number": "269-985-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 HEALTH PARK LN",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853421",
            "telephone_number": "269-985-4467",
            "fax_number": "269-429-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOTOBESOLA",
        "first_name": "AZRA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704311055",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704311055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.