Individual provider Active NPI

Deandra Stibich, NP

  • Gerontology Nurse Practitioner
  • Troy, MI
National Provider Identifier
1982299962
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704300301 Issued in MI
Practice address
500 Kirts Blvd Ste 100
Troy, MI 48084-4135
Phone
(248) 824-6500
Fax
(248) 686-0772
NPI assigned
Mar 2, 2021
Last updated
Apr 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704300301 MI Primary

Addresses

Primary practice location

500 Kirts Blvd Ste 100
Troy, MI 48084-4135

Mailing address

PO Box 40412
Belfast, ME 04915-1255
Phone (248) 824-6060

Other practice location 1

6814 Leslee Crest Dr
West Bloomfield, MI 48322-3726
Phone (248) 342-4281

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
I20210426002118 MI Practitioner - Nurse Practitioner 4385052638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vpa PCGroup PAC ID 9234041948, 181 clinicians

Practice addresses (Care Compare)

Troy, MI 48084
Phone (248) 824-6060

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704300301MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Jul 1, 2025 Accepting new patients
Vpa PC CurrentSince Jul 1, 2025 Accepting new patients
Vpa PC Current Accepting new patients
Wellbridge of Clarkston, LLC Past Accepting new patients

Locations

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

Interoperability endpoints

  • Direct secure messaging: deandra.stibich.1@27127.direct.athenahealth.com
  • Direct secure messaging: deandra.stibich.1@32913.direct.athenahealth.com
  • Direct secure messaging: dstibich1041680@direct.hfhs.org

Organizations & group practices 4

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": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1982299962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40412",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049151255",
            "telephone_number": "248-824-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 KIRTS BLVD STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844135",
            "telephone_number": "248-824-6500",
            "fax_number": "248-686-0772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6814 Leslee Crest Dr",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223726",
            "country_code": "US",
            "telephone_number": "248-342-4281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIBICH",
        "first_name": "DEANDRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704300301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.