Individual provider Active NPI

Roa Alnasiry

  • Physician Assistant
  • Dearborn Heights, MI
National Provider Identifier
1356228340
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1233854 Issued in MI
Practice address
27332 Kingswood Dr
Dearborn Heights, MI 48127-3382
Phone
(313) 899-0700
NPI assigned
Aug 20, 2025
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 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 1233854 MI Primary

Addresses

Primary practice location

27332 Kingswood Dr
Dearborn Heights, MI 48127-3382

Mailing address

27332 Kingswood Dr
Dearborn Heights, MI 48127-3382
Phone (313) 899-0700

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
I20260128001496 MI Practitioner - Physician Assistant 3678051000 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Michigan Medical School, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iep Urgent Care - Jackson PLLCGroup PAC ID 0042619132, 20 clinicians

Practice addresses (Care Compare)

729 E Michigan Ave
Jackson, MI 49201-1625
Phone (517) 539-3018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1233854MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iep Urgent Care - Jackson PLLC CurrentSince Dec 27, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

1602 W Michigan Ave
Jackson, MI 49202
Phone (517) 879-1166

729 E Michigan Ave
Jackson, MI 49201
Phone (517) 539-3018

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1356228340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27332 KINGSWOOD DR",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273382",
            "telephone_number": "313-899-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27332 KINGSWOOD DR",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273382",
            "telephone_number": "313-899-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALNASIRY",
        "first_name": "ROA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "1233854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.