NPIMap

Individual provider Active NPI

Deepa Bai Jagtap, M.D.

  • Hematology & Oncology Physician
  • Royal Oak, MI
National Provider Identifier
1629190095
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4301087460 Issued in MI
Practice address
3577 W 13 Mile Rd
Suite 103
Royal Oak, MI 48073-6710
Phone
(248) 288-4500
Fax
(248) 288-0450
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301087460 MI
Hematology & Oncology Physician 207RH0003X 4301087460 MI Primary

Addresses

Primary practice location

3577 W 13 Mile Rd
Suite 103
Royal Oak, MI 48073-6710

Mailing address

3577 W 13 Mile Rd
Suite 103
Royal Oak, MI 48073-6710
Phone (248) 288-4500

Other practice location 1

3581 W 13 Mile Rd Ste Bcc
Royal Oak, MI 48073-6710
Phone (248) 551-3300

Other identifiers 2

IdentifierTypeStateIssuer
700H273300OtherMIBLUE SHIELD
1629190095MedicaidMI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address djagtap463089@direct.beaumont.edu
Direct Messaging Address djagtap463089@direct.beaumont.edu

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
I20120710000694 MI Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - OphthalmologyPractitioner - Hematology 0941465348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Healthcare Professionals PC 525 clinicians

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group- Specialty Services CurrentSince Mar 21, 2018 Accepting new patients
Michigan Healthcare Professionals PC Internal Medicine CurrentSince Oct 1, 2014 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Oct 1, 2014 Accepting new patients
University Physician Group Internal Medicine Past Accepting new patients

Locations

6770 Dixie Hwy
Ste 107
Clarkston, MI 48346
Phone (248) 625-7506

6770 Dixie Hwy
Ste 106A
Clarkston, MI 48346
Phone (248) 625-2071

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

3601 W 13 Mile Rd
Ste Bcc
Royal Oak, MI 48073
Phone (248) 551-3300

3577 W 13 Mile Rd
Ste 103
Royal Oak, MI 48073
Phone (248) 288-4500

3581 W 13 Mile Rd
Ste Bcc
Royal Oak, MI 48073
Phone (248) 551-3300

3601 W 13 Mile Rd
Royal Oak, MI 48073

3577 W 13 Mile Rd
Royal Oak, MI 48073
Phone (248) 551-5490

44344 Dequindre Rd
Sterling Heights, MI 48314
Phone (248) 964-1460

4550 Investment Dr
Ste B120
Troy, MI 48098
Phone (248) 267-6569

Interoperability endpoints

  • Direct secure messaging: djagtap463089@direct.beaumont.edu
  • Direct secure messaging: djagtap1239534@epic00.shdirect.org

Organizations & group practices 12

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629190095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3577 W 13 MILE RD",
            "address_2": "SUITE 103",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-288-4500",
            "fax_number": "248-288-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3577 W 13 MILE RD",
            "address_2": "SUITE 103",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-288-4500",
            "fax_number": "248-288-0450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3581 W 13 Mile Rd Ste Bcc",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736710",
            "country_code": "US",
            "telephone_number": "248-551-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAGTAP",
        "first_name": "DEEPA",
        "middle_name": "BAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301087460",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301087460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "700H273300",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629190095",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "djagtap463089@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3577 W 13 Mile Rd",
            "address_2": "Suite 103",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "djagtap463089@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3581 W 13 Mile Rd Ste Bcc",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.