Michael Jacoby, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4301042676 Issued in MI

Practice address

555 Linn St
Allegan, MI 49010-1524

Phone

(616) 235-4800

NPI assigned

May 26, 2006

Last updated

Sep 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Advanced Radiology Services PC

  • Diagnostic Radiology Physician
  • Grand Rapids, MI
  • NPI 1740283324
  NPD (past)
• Encourage Counseling LLC

  • Clinical Social Worker
  • Holland, MI
  • NPI 1417101726
  NPD (past)
• Southwest Mi Radiology PLLC

  • Diagnostic Radiology Physician
  • Allegan, MI
  • NPI 1679510572
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1538115803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 BECKLEY RD",
            "address_2": "SUITE C",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490154178",
            "telephone_number": "269-979-9400",
            "fax_number": "269-979-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 LINN ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101524",
            "telephone_number": "616-235-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301042676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PIN",
            "identifier": "DD4837",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4860092",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4860083",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "310A710590",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angel Hopkins, R.N
• Kodi Hudson
• Josie Jane Huizenga, LMSW
• Erin Hurley
• Sara Irish, LLMSW
• Syed Saeed Jafri, MD
• Raymond Jaglowski, M.D.
• Jamor James, ACTT THERAPIST
• Wallace Glenn Jamison, MD
• Julia Ann Jenkins, REGISTERED DIETITIAN

• Diagnostic Radiology Physician in Allegan, MI
• Providers in Allegan, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.