Jacob R Deboni, FNP
Individual provider Active NPI Family Nurse Practitioner · Manistee, MI
NPI 1578036091 · NPPES record last updated Jun 24, 2026
Key facts
- NPI
- 1578036091
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704285441 (MI)
- Practice address
- 72 Filer St
Manistee, MI 49660-2717 - Phone
- (231) 723-5600
- Fax
- (231) 723-1048
- NPI assigned
- Jan 8, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lakeshore Family Care PC
Practice addresses (Care Compare)
72 Filer St
Manistee, MI 49660-2717
Phone (231) 723-5600
Hospital & facility affiliations
- Munson Healthcare Manistee Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190207000516 | MI | Practitioner - Nurse Practitioner | 7810235488 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Munson Healthcare Cadillac | Current |
Accepting new patients | |
| Lakeshore Family Care, PC | Current |
Accepting new patients | |
| Munson Healthcare Manistee Hospital | Current |
Accepting new patients | |
| Munson Healthcare Cadillac | Current | Accepting new patients | |
| Munson Healthcare Cadillac | Current |
Accepting new patients | |
| Munson Healthcare Manistee Hospital | Current |
Accepting new patients |
Locations
3782 Momentum Pl
Chicago, IL 60689
400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200
8872 Professional Dr
Ste B
Cadillac, MI 49601
Phone (231) 779-0320
917 Main St
Frankfort, MI 49635
Phone (231) 352-2201
72 Filer St
Manistee, MI 49660
Phone (231) 397-1903
1465 E Parkdale Ave
Manistee, MI 49660
Phone (231) 398-1000
1345 E Parkdale Ave
Manistee, MI 49660
Phone (231) 398-1740
1293 E Parkdale Ave
Manistee, MI 49660
Phone (231) 398-1735
1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000
Interoperability endpoints
- jdeboni@direct.mhc.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704285441 | MI | Yes |
Addresses
Primary practice location
72 Filer St
Manistee, MI 49660-2717
Mailing address
72 Filer St
Manistee, MI 49660-2717
Phone (231) 723-5600
Other providers in Manistee, MI
- Mark Salvatore Dangelo
- Daniel & Max, LLC
- Michael Dark
- Hillary J Davis
- Jessica Jo Dawson
- Christina Delacruz
- Jessica Derosia
- Michael Donald Dincau
- Cheryl Dionne
- Dale M Dixon
All providers in Manistee, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.