NPIMap

Individual provider Active NPI

Keith M Tobin, D.O.

  • Geriatric Medicine (Family Medicine) Physician
  • Livonia, MI
National Provider Identifier
1083611560
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
5101010694 Issued in MI
Practice address
28701 Plymouth Rd
Livonia, MI 48150-2335
Phone
(734) 427-9900
Fax
(734) 427-8963
NPI assigned
Jun 30, 2005
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101010694 MI
Geriatric Medicine (Family Medicine) Physician 207QG0300X 5101010694 MI Primary

Addresses

Primary practice location

28701 Plymouth Rd
Livonia, MI 48150-2335

Mailing address

28701 Plymouth Rd
Livonia, MI 48150-2335
Phone (734) 427-9900

Other identifiers 7

IdentifierTypeStateIssuer
5820442OtherMIBCBS PROVIDER ID
993699OtherMIAETNA PROVIDER ID
P86747OtherMIBCN PROVIDER ID
4082200MedicaidMI
C4002OtherMIMCARE PROVIDER ID
F05096OtherMIHAP PROVIDER ID
5101010694OtherMISTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020000928 MI Practitioner - Family PracticePractitioner - Geriatric Medicine 3678542008 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
University of New England, College of Osteo Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Geriatric Consultants PLCGroup PAC ID 1951370386, 4 clinicians
Keith M Tobin DO PCGroup PAC ID 4284738873, 2 clinicians

Practice addresses (Care Compare)

14265 Middlebelt Rd
Livonia, MI 48154-4585
Phone (734) 261-2884

15775 Middlebelt Rd
Livonia, MI 48154-3809
Phone (734) 522-5780

16100 N Haggerty Rd
Plymouth, MI 48170-4857
Phone (734) 420-4000

28701 Plymouth Rd
Livonia, MI 48150-2335
Phone (734) 427-9900

28701 Plymouth Rd
Livonia, MI 48150-2419
Phone (734) 427-9900

32500 7 Mile Rd
Livonia, MI 48152-1340
Phone (248) 426-7055

39201 Joy Rd
Westland, MI 48185-7543
Phone (734) 454-9838

40033 8 Mile Rd
Northville, MI 48167-1954
Phone (248) 349-0400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Keith M Tobin DO PC Family Medicine CurrentSince Oct 20, 1998 Accepting new patients
American Geriatric Consultants PLC Family Medicine CurrentSince Jan 1, 1995 Accepting new patients
Metro Man II Inc Past Accepting new patients
Fountain Bleu Health and Rehabilitation Center Inc Past Accepting new patients
American Geritric Consultants LLC Geriatric Medicine Past Accepting new patients

Locations

28701 Plymouth Rd
Livonia, MI 48150
Phone (313) 937-1190

27144 Joy Rd
Redford, MI 48239
Phone (313) 410-6003

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCJACA/Endpoint/DCJACA

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.

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1083611560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28701 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502335",
            "telephone_number": "734-427-9900",
            "fax_number": "734-427-8963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28701 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502335",
            "telephone_number": "734-427-9900",
            "fax_number": "734-427-8963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "KEITH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101010694",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "5101010694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "5820442",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "993699",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN PROVIDER ID",
            "identifier": "P86747",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4082200",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE PROVIDER ID",
            "identifier": "C4002",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP PROVIDER ID",
            "identifier": "F05096",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "5101010694",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.