Individual provider Active NPI

Ashley Boller, PA-C

  • Physician Assistant
  • Ypsilanti, MI
National Provider Identifier
1386182186
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012157 Issued in MI
Practice address
5333 McAuley Dr
Suite 6109
Ypsilanti, MI 48197
Phone
(734) 712-1400
Fax
(734) 623-2857
NPI assigned
Feb 1, 2017
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C5-0001216 DE
Physician Assistant 363A00000X PA9109725 FL
Physician Assistant 363A00000X 5601012157 MI Primary

Addresses

Primary practice location

5333 McAuley Dr
Suite 6109
Ypsilanti, MI 48197

Mailing address

24 Frank Lloyd Wright Drive
Suite J2000
Ann Arbor, MI 48105
Phone (734) 747-6766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180604000046 DE Practitioner - Physician Assistant 5799060539 Reassigns benefits to 2 organizations
I20240122003157 MI Practitioner - Physician Assistant 5799060539 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians
St Joseph Mercy HospitalGroup PAC ID 3779489281, 69 clinicians

Practice addresses (Care Compare)

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C5-0001216DEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Mercy Livingston Hospital CurrentSince Dec 9, 2023 Accepting new patients
Iha Health Services Corporation CurrentSince Apr 20, 2024 Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Dec 9, 2023 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Jul 1, 2019 Accepting new patients
St Joseph Mercy Hospital Physician Assistant CurrentSince Dec 9, 2023 Accepting new patients
Christiana Care Health Services Inc CurrentSince Jun 17, 2018 Accepting new patients
Christiana Care Health Services Inc CurrentSince Jun 17, 2018 Accepting new patients
St Joseph Mercy Hospital CurrentSince Dec 9, 2023 Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients

Locations

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

4755 Ogletown Stanton Rd
Ste 2E99
Newark, DE 19718
Phone (302) 623-3017

774 Christiana Rd
Ste 201
Newark, DE 19713
Phone (302) 623-3017

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

7575 Grand River Rd
Brighton, MI 48114
Phone (810) 844-7544

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

5333 McAuley Dr
Rm 6109
Ypsilanti, MI 48197
Phone (734) 712-8600

Interoperability endpoints

  • Direct secure messaging: aboller3271390@direct.trinity-health.org

Organizations & group practices 11

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.

Hospital & facility affiliations 1

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": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1386182186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DRIVE",
            "address_2": "SUITE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR",
            "address_2": "SUITE 6109",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48197",
            "telephone_number": "734-712-1400",
            "fax_number": "734-623-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLER",
        "first_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-01",
        "last_updated": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0001216",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109725",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.