Roger Allen Mausolf, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601006344 Issued in MI

Practice address

8020 Davison Rd
Davison, MI 48423-2029

Phone

(810) 653-4145

NPI assigned

May 22, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Wayne State University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rogermausolf@pmi.allscriptsdirect.net

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.

• Henry Ford Medical Group Genesys

  • Family Medicine Physician
  • Burton, MI
  • NPI 1598248718
  Medicare reassignment Care Compare group
• Henry Ford Medical Group Genesys

  • Family Medicine Physician
  • Mount Morris, MI
  • NPI 1003398470
  NPD
• Henry Ford Medical Group Genesys

  • Physical Therapist
  • Burton, MI
  • NPI 1114495793
  NPD

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

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1174883359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8020 DAVISON RD",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484232029",
            "telephone_number": "810-653-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUSOLF",
        "first_name": "ROGER",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-22",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Martin, RN
• Marie Lynn Mata
• Kathleen Lucille Mataway, RN, BSN, IBCLC
• Eric Mather, D.C.
• Casey Maul, PT
• Theresa Ann Mays
• Marney Ann McCleskey, FNP
• Nathanial Paul McKee, D.C.
• McLaren Health Management Group
• McLaren Health Management Group

• Medical Physician Assistant in Davison, MI
• Providers in Davison, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.