Individual provider Active NPI

Mark Roby, PAC

  • Physician Assistant
  • Farmington Hills, MI
National Provider Identifier
1770536989
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MR001689 Issued in MI
Practice address
30840 Northwestern Hwy
Ste 110
Farmington Hills, MI 48334-2552
Phone
(248) 626-7544
Fax
(248) 626-9698
NPI assigned
May 18, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 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 MR001689 MI Primary

Addresses

Primary practice location

30840 Northwestern Hwy
Ste 110
Farmington Hills, MI 48334-2552

Mailing address

1245 Derby Rd
#7
Birmingham, MI 48009-5809
Phone (248) 318-8775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WI, MN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20060207000567 MI Practitioner - Physician Assistant 1052326402 Reassigns benefits to 1 organization
I20190924001528 WI Practitioner - Physician Assistant 1052326402 Reassigns benefits to 1 organization
I20220607000796 MN Practitioner - Physician Assistant 1052326402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Behavioral Care Solutions for Adults and Seniors IncGroup PAC ID 4880918051, 71 clinicians

Practice addresses (Care Compare)

1245 Derby Rd
Birmingham, MI 48009-5809
Phone (248) 859-3900

39465 W 14 Mile Rd
Novi, MI 48377-1600
Phone (877) 906-9699

445 Minnesota St
Suite 1500
Saint Paul, MN 55101-2269
Phone (651) 256-9400

Merit-based Incentive Payment System (MIPS)

Final score
57.96 of 100Reported as group
Quality
21.71
Promoting interoperability
12
Improvement activities
40
Cost
78.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MR001689MIMDPhysician Assistant
14057MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Psychiatric Services PLLC Past Accepting new patients
Embrace Home Physicians PLLC PastSince Nov 21, 2016 Accepting new patients
Farmington Hills Medical Center, PC Past Accepting new patients

Organizations & group practices 5

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1770536989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 DERBY RD",
            "address_2": "#7",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480095809",
            "telephone_number": "248-318-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30840 NORTHWESTERN HWY",
            "address_2": "STE 110",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342552",
            "telephone_number": "248-626-7544",
            "fax_number": "248-626-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBY",
        "first_name": "MARK",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "MR001689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.