Individual provider Active NPI

Hilarion Bibicoff, D.O.

  • Family Medicine Physician
  • Traverse City, MI
National Provider Identifier
1114367703
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101020506 Issued in MI
Practice address
4290 Copper Ridge Dr Ste 200
Traverse City, MI 49684-7205
Phone
(231) 935-8930
Fax
(231) 935-8811
NPI assigned
Jun 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101020506 MI Primary

Addresses

Primary practice location

4290 Copper Ridge Dr Ste 200
Traverse City, MI 49684-7205

Mailing address

4290 Copper Ridge Dr Ste 200
Traverse City, MI 49684-7205
Phone (231) 935-8930

Other identifiers 1

IdentifierTypeStateIssuer
5101020506OtherMILICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160728000381 MI Practitioner - Family Practice 6406166628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Front Primary Care PLLCGroup PAC ID 4183514706, 20 clinicians

Practice addresses (Care Compare)

4290 Copper Ridge Dr
Suite 200
Traverse City, MI 49684-7205
Phone (231) 935-8930

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center Current Accepting new patients
Munson Medical Center CurrentSince Jan 28, 2017 Accepting new patients
Munson Medical Center Family Medicine CurrentSince Jan 28, 2017 Accepting new patients
West Front Primary Care, P.L.L.C. Family Medicine CurrentSince Jul 13, 2016 Accepting new patients
West Front Primary Care, P.L.L.C. Family Medicine PastSince Jul 13, 2016 Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

3537 W Front St
Ste E
Traverse City, MI 49684
Phone (231) 935-5880

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

4290 Copper Ridge Dr
Ste 200
Traverse City, MI 49684
Phone (231) 935-8930

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

550 Munson Ave
Traverse City, MI 49686
Phone (231) 935-6600

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: lee.bibicoffdo.p1@direct.wfpc.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1114367703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 COPPER RIDGE DR STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847205",
            "telephone_number": "231-935-8930",
            "fax_number": "231-935-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 COPPER RIDGE DR STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847205",
            "telephone_number": "231-935-8930",
            "fax_number": "231-935-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBICOFF",
        "first_name": "HILARION",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101020506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5101020506",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.