Individual provider Active NPI

Jana Dbaibou, M.D.

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1558852871
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30542 Issued in WV
Practice address
4201 St. Antoine St.
Suite 2E
Detroit, MI 48201
Phone
(313) 745-7888
NPI assigned
May 22, 2018
Reactivated
Mar 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30542 WV Primary

Addresses

Primary practice location

4201 St. Antoine St.
Suite 2E
Detroit, MI 48201

Mailing address

PO Box 9156
Morgantown, WV 26506-9156
Phone (313) 745-7888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20211012000073 WV Practitioner - Internal Medicine 1052667276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30542WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 1, 2021 Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

6040 University Town Centre Dr
Morgantown, WV 26501

Interoperability endpoints

  • Direct secure messaging: jdbaibou269834@direct.wvuhsdirect.com

Organizations & group practices 2

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 2

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": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1558852871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9156",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265069156",
            "telephone_number": "313-745-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 ST. ANTOINE ST.",
            "address_2": "SUITE 2E",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DBAIBOU",
        "first_name": "JANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "deactivation_date": "2019-01-22",
        "reactivation_date": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "30542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.