Individual provider Active NPI

Ryan Hensley, PA-C

  • Physician Assistant
  • Center Line, MI
National Provider Identifier
1972001584
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008547 Issued in MI
Practice address
25429 Van Dyke Ave
Center Line, MI 48015-1825
Phone
(586) 759-1100
NPI assigned
Jan 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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 5601008547 MI Primary

Addresses

Primary practice location

25429 Van Dyke Ave
Center Line, MI 48015-1825

Mailing address

25429 Van Dyke Ave
Center Line, MI 48015-1825

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
I20200528002865 MI Practitioner - Physician Assistant 0143641100 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Choice Urgent Care PCGroup PAC ID 9739221912, 45 clinicians

Practice addresses (Care Compare)

23455 Michigan Ave
Dearborn, MI 48124-1908

25515 Harper Ave
Saint Clair Shores, MI 48081-2209
Phone (586) 435-0160

3280 Washtenaw Ave
Ann Arbor, MI 48104-4283
Phone (313) 767-3380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Urgent Care, P.C. CurrentSince Apr 3, 2021 Accepting new patients
Rochester Urgent Care, P. C. CurrentSince Apr 3, 2021 Accepting new patients
Somerset Urgent Care PLLC CurrentSince May 1, 2020 Accepting new patients
First Choice Medical Group PLLC Past Accepting new patients
Oxford Urgent Care, LLC Past Accepting new patients

Locations

44472 Hayes Rd
Clinton Twp, MI 48038
Phone (586) 412-0890

2952 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 853-2009

215 E Auburn Rd
Rochester Hills, MI 48307
Phone (248) 853-2009

1500 W Big Beaver Rd
Ste 104
Troy, MI 48084
Phone (248) 649-4444

31200 Mound Rd
Warren, MI 48092
Phone (248) 850-8395

Interoperability endpoints

  • Direct secure messaging: ryan.hensley.1@20203.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20203/brand/1/csg/1/fhir/r4

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1972001584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25429 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25429 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151825",
            "telephone_number": "586-759-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-29",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Center Line, MI

Sources for this page

Verify at the official NPI Registry.