Individual provider Active NPI

Layan Haidous

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1497621411
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4001 W McNichols Rd
Detroit, MI 48221-3038
Phone
(313) 993-1245
NPI assigned
Oct 15, 2025
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 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 MI Primary

Addresses

Primary practice location

4001 W McNichols Rd
Detroit, MI 48221-3038

Mailing address

4001 W McNichols Rd
Detroit, MI 48221-3038

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
I20260609001386 MI Practitioner - Physician Assistant 0345711537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

125 N Lafayette St
Dearborn, MI 48128-1522

5820 N Canton Ctr Rd
Suite 186
Canton, MI 48187-2651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Detroit Mercy PastSince Oct 21, 2025 Accepting new patients

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": "1760486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1497621411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482213038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482213038",
            "telephone_number": "313-993-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDOUS",
        "first_name": "LAYAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.