Individual provider Active NPI

Jeff Y The, D.O.

  • Internal Medicine Physician
  • Plymouth, MI
National Provider Identifier
1710940242
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
JT011068 Issued in MI
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, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 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

IdentifierTypeStateIssuer
1158207454OtherMIBCBS
4530838MedicaidMI
103654OtherMICARE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
JT011068MIMDInternal Medicine Physician

Hospital & facility affiliations 4

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": "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

Verify at the official NPI Registry.