Individual provider Active NPI

Ashleigh Kay Wisser, PA-C

  • Physician Assistant
  • Canton, MI
National Provider Identifier
1710364807
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010505 Issued in MI
Practice address
361 N Canton Center Rd
Canton, MI 48187-5096
Phone
(734) 495-1506
Fax
(734) 495-1780
NPI assigned
Apr 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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 5601010505 MI Primary

Addresses

Primary practice location

361 N Canton Center Rd
Canton, MI 48187-5096

Mailing address

4856 Split Rail Dr
Brighton, MI 48114-7517
Phone (734) 495-1506

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
I20210720001869 MI Practitioner - Physician Assistant 7012224868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Specialists of Canton PLLCGroup PAC ID 6507923976, 18 clinicians

Practice addresses (Care Compare)

361 N Canton Ctr Rd
Canton, MI 48187
Phone (734) 495-1506

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601010505MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Audrey Bruell, M.D. P.C. Current Accepting new patients
Rediclinic Austin, LLC CurrentSince Jul 2, 2016 Accepting new patients
Alan Bolton, MD, PC PastSince Mar 1, 1999 Accepting new patients

Locations

37605 Pembroke Ave
Livonia, MI 48152
Phone (734) 591-7931

500 Canyon Ridge Dr
Austin, TX 78753
Phone (512) 836-9000

170 E Whitestone Blvd
Cedar Park, TX 78613
Phone (512) 259-5755

Organizations & group practices 4

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.

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": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1710364807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 SPLIT RAIL DR",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147517",
            "telephone_number": "734-495-1506",
            "fax_number": "734-495-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 N CANTON CENTER RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875096",
            "telephone_number": "734-495-1506",
            "fax_number": "734-495-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSER",
        "first_name": "ASHLEIGH",
        "middle_name": "KAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.