LEISA DETTLOFF
NPI 1972156818
Nurse Practitioner - Family in Troy, MI
About Leisa Dettloff NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LEISA DETTLOFF (NPI 1972156818) is an individual family provider in Troy, Michigan, licensed in Michigan (4704292580) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Leisa Dettloff is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Leisa Dettloff reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Royal Oak, MI 48073
- Reassigned Medicare billing, Michigan enrollment
- 946 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48085 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
TROY, MI 48085
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Leisa Dettloff's NPI number?
The NPI number for Leisa Dettloff is 1972156818. It was assigned to this individual provider in the NPPES registry on July 19, 2019.
Where is Leisa Dettloff located?
Leisa Dettloff practices at 44201 Dequindre Rd, Troy, MI 48085. The listed phone number is (248) 964-5000.
What is Leisa Dettloff's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Leisa Dettloff enrolled in Medicare?
Yes. Leisa Dettloff is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Leisa Dettloff's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Leisa Dettloff reassigns Medicare benefits to Beaumont Medical Group Hospital -Based Services (Royal Oak, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Leisa Dettloff's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Leisa Dettloff accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Priority Health list Leisa Dettloff as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Leisa Dettloff was last updated on July 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Leisa Dettloff · NPI 1972156818
Family physician in Troy, Michigan. Individual provider, active in the CMS NPPES registry since July 19, 2019.
## Identity
- **NPI:** 1972156818 (Entity type: Individual)
- **Enumerated:** July 19, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 4704292580 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 44201 DEQUINDRE RD, Troy, MI 48085-1117
- **Phone:** (248) 964-5000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Beaumont Medical Group Hospital -Based Services (NPI 1427567858, Royal Oak, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** July 15, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1972156818) · Data from the CMS NPPES public registry.