Individual provider Active NPI

Roby N Yousif, PA-C

  • Physician Assistant
  • Dearborn, MI
National Provider Identifier
1043957087
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011139 Issued in MI
Practice address
23455 Michigan Ave
Dearborn, MI 48124-1908
Phone
(734) 333-8001
Fax
(734) 333-8002
NPI assigned
May 19, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601011139 MI Primary

Addresses

Primary practice location

23455 Michigan Ave
Dearborn, MI 48124-1908

Mailing address

4203 Angeline Dr
Sterling Heights, MI 48310-5004
Phone (248) 462-9958

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
I20220602001170 MI Practitioner - Physician Assistant 0042698193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Choice Urgent Care PCGroup PAC ID 9739221912, 45 clinicians

Practice addresses (Care Compare)

2274 S Telegraph Rd
Bloomfield, MI 48302-0252
Phone (248) 451-0933

23455 Michigan Ave
Dearborn, MI 48124-1908

25600 Schoenherr Rd
Warren, MI 48089-1447
Phone (586) 480-2080

7701 26 Mile Rd
Washington, MI 48094-2804
Phone (248) 280-1080

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Occmed Connect LLC CurrentSince Jan 14, 2024 Accepting new patients
First Choice Medical Group PLLC Past Accepting new patients

Locations

23455 Michigan Ave
Dearborn, MI 48124
Phone (313) 438-6094

23455 Michigan Ave
Ste A
Dearborn, MI 48124
Phone (734) 333-8001

Interoperability endpoints

  • Direct secure messaging: roby.yousif.1@20203.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20203/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1043957087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 ANGELINE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105004",
            "telephone_number": "248-462-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23455 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241908",
            "telephone_number": "734-333-8001",
            "fax_number": "734-333-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSIF",
        "first_name": "ROBY",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.