Individual provider Active NPI

Ansaf Alamin Roy

  • Physician Assistant
  • Peoria, IL
National Provider Identifier
1811855893
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085011995 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-2000
NPI assigned
Jan 9, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085011995 IL Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 50.010009RX OH

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

106 Laurel LN
Euless, TX 76039-8005
Phone (469) 254-1098

Other practice location 1

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (716) 829-8000

Other practice location 2

6780 Mayfield Rd
Mayfield Heights, OH 44124-2294
Phone (469) 254-1098

Other practice location 3

18101 Lorain Ave
Cleveland, OH 44111-5612
Phone (216) 476-7000 ext. 41098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20260218003283 OH Practitioner - Physician Assistant 4385124262 Reassigns benefits to 1 organization
I20260224004088 IL Practitioner - Physician Assistant 4385124262 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)

1001 Main St
Suite 200
Peoria, IL 61606-1907

124 SW Adams St
Peoria, IL 61602-1308

6801 Brecksville Rd
Suite 20
Independence, OH 44131-5058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50.010009RXOHMDCritical Care Medicine (Internal Medicine) Physician
085011995ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Feb 5, 2026 Accepting new patients
Osf Multi-Specialty Group CurrentSince Feb 12, 2026 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

18101 Lorain Ave
Cleveland, OH 44111
Phone (216) 476-7029

6780 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 331-9520

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1767916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1811855893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 LAUREL LN",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760398005",
            "telephone_number": "469-254-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441950001",
            "country_code": "US",
            "telephone_number": "716-829-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6780 Mayfield Rd",
            "address_purpose": "LOCATION",
            "city": "Mayfield Heights",
            "state": "OH",
            "postal_code": "441242294",
            "country_code": "US",
            "telephone_number": "469-254-1098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18101 Lorain Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441115612",
            "country_code": "US",
            "telephone_number": "216-476-7000 x41098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROY",
        "first_name": "ANSAF",
        "middle_name": "ALAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-09",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085011995",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "50.010009RX",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.