Individual provider Active NPI

Bup Ngoc Le

  • Family Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1609508555
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704342794 Issued in MI
Practice address
5557 Cass Ave
Detroit, MI 48202-3615
Phone
(313) 577-6949
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704342794 MI Primary

Addresses

Primary practice location

5557 Cass Ave
Detroit, MI 48202-3615

Mailing address

5557 Cass Ave
Detroit, MI 48202-3615
Phone (313) 577-6949

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
I20250304002789 MI Practitioner - Nurse Practitioner 5092236299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

27810 Grand River Ave
Farmington Hills, MI 48336-5916
Phone (248) 957-1989

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet Urgent Care of Michigan CurrentSince Feb 24, 2025 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients

Locations

1825 Highway 34 E
Ste 1200
Newnan, GA 30265
Phone (770) 502-2121

27810 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 516-1978

2078 E Big Beaver Rd
Troy, MI 48083
Phone (248) 855-4134

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 12

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1609508555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5557 CASS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023615",
            "telephone_number": "313-577-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5557 CASS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023615",
            "telephone_number": "313-577-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "BUP",
        "middle_name": "NGOC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704342794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.