NPIMap

Individual provider Active NPI

Bibban Bant Kaur Deol, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Detroit, MI
National Provider Identifier
1659320737
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
4301078546 Issued in MI
Practice address
4201 St. Antoine
Suite 5B
Detroit, MI 48201-2153
Phone
(313) 745-1741
Fax
(313) 745-8165
NPI assigned
May 8, 2006
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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 4301078546 MI
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 4301078546 MI Primary

Addresses

Primary practice location

4201 St. Antoine
Suite 5B
Detroit, MI 48201-2153

Mailing address

400 Mack Ave
Detroit, MI 48201-2136

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
I20060608000040 MI Practitioner - Geriatric MedicinePractitioner - Internal Medicine 6709898836 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

3400 Livernois Rd
Troy, MI 48083-5231
Phone (586) 434-0333

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (888) 264-0102

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Internal Medicine CurrentSince Oct 1, 2006 Accepting new patients
Aspan Medical Services, PLLC Internal Medicine CurrentSince May 19, 2017 Accepting new patients
Health Emergency Assistance of Detroit CurrentSince Sep 4, 2020 Accepting new patients
VHS Physicians of Michigan Internal Medicine Past Accepting new patients
University Physician Group Past Accepting new patients
VHS Detroit Receiving Hospital Inc Past Accepting new patients

Locations

36380 Garfield Rd
Ste 6
Clinton Twp, MI 48035

1726 Howard St
Detroit, MI 48216
Phone (313) 338-3740

400 Mack Ave
Detroit, MI 48201
Phone (313) 448-9006

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

4201 Saint Antoine St
Ste 5B
Detroit, MI 48201
Phone (313) 745-1741

50 E Canfield St
Detroit, MI 48201
Phone (313) 577-9704

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

1560 E Maple Rd
Ste 400
Troy, MI 48083

Interoperability endpoints

  • Direct secure messaging: bdeol@direct.dmc.org

Organizations & group practices 6

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 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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1659320737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 ST. ANTOINE",
            "address_2": "SUITE 5B",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-1741",
            "fax_number": "313-745-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEOL",
        "first_name": "BIBBAN BANT",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301078546",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "4301078546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.