Individual provider Active NPI

Ashlee Marie Dyja

  • Physician Assistant
  • Mt Pleasant, MI
National Provider Identifier
1073480190
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1227804 Issued in MI
Practice address
1200 S Franklin St
Mt Pleasant, MI 48859-2001
Phone
(248) 520-6621
NPI assigned
Oct 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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 1227804 MI Primary

Addresses

Primary practice location

1200 S Franklin St
Mt Pleasant, MI 48859-2001

Mailing address

1200 S Franklin St
Mt Pleasant, MI 48859-2001
Phone (248) 520-6621

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
I20260409002211 MI Practitioner - Physician Assistant 5193290922 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Central Michigan College of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10625 W N Ave
Suite 101
Milwaukee, WI 53226-2315

PO Box
Detroit, MI 48267

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1227804MIMDPhysician Assistant

Organizations & group practices 2

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": "1761091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1073480190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S FRANKLIN ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488592001",
            "telephone_number": "248-520-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S FRANKLIN ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488592001",
            "telephone_number": "248-520-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYJA",
        "first_name": "ASHLEE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "1227804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.