Lara Nassar

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601013454 Issued in MI

Practice address

21000 W 10 Mile Rd
Southfield, MI 48075-1051

Phone

(313) 380-0527

NPI assigned

Mar 28, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1811920549

  Physician Assistant

  Medicare reassignment NPD
• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1184471690
  NPD

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

{
    "created_epoch": "1743120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1780487561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751051",
            "telephone_number": "313-380-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751051",
            "telephone_number": "313-380-0527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Beaubien St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012119",
            "country_code": "US",
            "telephone_number": "313-745-5870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASSAR",
        "first_name": "LARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-28",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601013454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dipti N Narula, CRNA
• Deanna R Nash
• Domenique Nash
• Roseanna Nash
• Iqbal Nasir, MD
• Mariam Nassar
• Abtahal Nasser
• Mariam Nasser, MD
• Patrick Nassrallah, MD
• Natalie Savoy PLLC

• Physician Assistant in Southfield, MI
• Providers in Southfield, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.