Active NPI
Jeff Y The, D.O.
- Internal Medicine Physician
- Plymouth, MI
National Provider Identifier
1710940242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- JT011068
- Practice address
- 990 W Ann Arbor TRL
Suite 202
Plymouth, MI 48170-6204 - Phone
- (734) 455-8497
- Fax
- (734) 455-7907
- NPI assigned
- Apr 7, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | JT011068 | MI | Primary |
Addresses
Primary practice location
990 W Ann Arbor TRL
Suite 202
Plymouth, MI 48170-6204
Mailing address
990 W Ann Arbor TRL
Suite 202
Plymouth, MI 48170-6204
Phone (734) 455-8497
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1158207454 | Other | MI | BCBS |
| 4530838 | Medicaid | MI | |
| 103654 | Other | MI | CARE CHOICES/PREFERRED CH |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080613000314 | MI | Practitioner - Internal Medicine | 9638240948 | Practice locations: Plymouth, MI; Ypsilanti, MI; Livonia, MI |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Michigan State University College of Osteopathic Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone (734) 712-3456
990 W Ann Arbor Trail
Suite 100
Plymouth, MI 48170-1686
Phone (734) 455-8497
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JT011068 | MI | MD | Internal Medicine Physician |
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Troy, MI
- NPI 1992768550
-
- General Acute Care Hospital
- Brighton, MI
- NPI 1093748642
-
dba Trinity Heath Ann Arbor Hospital
- General Acute Care Hospital
- Ypsilanti, MI
- NPI 1780658443
-
- General Acute Care Hospital
- Livonia, MI
- NPI 1790706901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1710940242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 W ANN ARBOR TRL",
"address_2": "SUITE 202",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481706204",
"telephone_number": "734-455-8497",
"fax_number": "734-455-7907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 W ANN ARBOR TRL",
"address_2": "SUITE 202",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481706204",
"telephone_number": "734-455-8497",
"fax_number": "734-455-7907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THE",
"first_name": "JEFF",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-07",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "JT011068",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1158207454",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4530838",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE CHOICES/PREFERRED CH",
"identifier": "103654",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.