Organization Active NPI

Qasawa Plastic Surgery, PLLC

  • Plastic and Reconstructive Surgery Physician
  • Troy, MI
National Provider Identifier
1508658907
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
QASAWA PLASTIC SURGERY, PLLC
Practice address
1080 Kirts Blvd Ste 700
Troy, MI 48084-4853
Phone
(248) 362-2300
NPI assigned
May 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Authorized official

Name
Dr. Ryan Qasawa, DONPI 1134650831
Title
Owner
Phone
(586) 630-7699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X Primary
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

1080 Kirts Blvd Ste 700
Troy, MI 48084-4853

Mailing address

1080 Kirts Blvd Ste 700
Troy, MI 48084-4853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250710001446 MI Part B Supplier - Clinic/Group Practice 7214441252 Receives reassigned benefits from 1 practitioner
Practice locations: Troy, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1508658907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 KIRTS BLVD STE 700",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 KIRTS BLVD STE 700",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844853",
            "telephone_number": "248-362-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QASAWA PLASTIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "QASAWA",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-630-7699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.