JACOB VANDERSTARRE M.D.
NPI 1003267782
Emergency Medicine in Salem, OR

Q: What is Jacob Vanderstarre's NPI number?

The NPI number for Jacob Vanderstarre is 1003267782. It was assigned to this individual provider in the NPPES registry on June 24, 2016.

Q: What is Jacob Vanderstarre's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Active since June 24, 2016PECOS EnrolledAccepts Medicare Assignment

890 OAK ST SE BLDG A, SALEM, OR 97301(855) 691-9890 Get Directions Write a Review

NPPES record last updated: June 21, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 21, 2019, Jun 24, 2016 (2 updates tracked since 2016).

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About Jacob Vanderstarre M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB VANDERSTARRE M.D. (NPI 1003267782) is an individual emergency medicine provider in Salem, Oregon, licensed in Oregon (MD191574) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, is affiliated with Bronson Methodist Hospital, and maintains a secondary practice location in Grand Rapids.

NPPES Registry Identity

NPI1003267782

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameJACOB VANDERSTARRECredential: M.D.

Location Address890 OAK ST SE BLDG ASalem, OR 97301

Mailing Address890 Oak St Se Bldg ASalem, OR 97301-3905 · (855) 691-9890

Phone(855) 691-9890

Sole ProprietorNo

Medical School CMSWayne State University School Of MedicineGraduated 2016

Enumeration DateJune 24, 2016

Last NPPES UpdateJune 21, 20192 updates tracked since enumeration

✔ NPI 1003267782 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

Licenses✔ Licensed in OR · MD191574✔ Licensed in MI · 4301109907

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

890 OAK ST SE BLDG A, Salem, OR 97301

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Secondary Practice Location 1

Location 1100 Michigan St NEGrand Rapids, MI 49503-2560 · Phone (616) 391-1680

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob Vanderstarre M.d. 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.

PECOS PAC ID6103112289

PECOS Enrollment IDI20190514003260

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

216 services213 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

151 services148 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

114 services108 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

57 services56 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bronson Methodist Hospital

Acute Care Hospitals · Kalamazoo, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230017

Location601 John StreetKalamazoo, MI 49007 · Kalamazoo County

Emergency services Birthing friendly

Bronson Battle Creek Hospital

Acute Care Hospitals · Battle Creek, MI

4/5 CMS rating

OwnershipProprietary

CMS Certification Number230075

Location300 North AvenueBattle Creek, MI 49017 · Calhoun County

Emergency services Birthing friendly

Bronson South Haven Hospital

Acute Care Hospitals · South Haven, MI

OwnershipGovernment - Hospital District or Authority

CMS Certification Number230085

Location955 S Bailey AveSouth Haven, MI 49090 · Van Buren County

Emergency services

Bronson Lakeview Hospital

Critical Access Hospitals · Paw Paw, MI

OwnershipVoluntary non-profit - Private

CMS Certification Number231332

Location408 Hazen StreetPaw Paw, MI 49079 · Van Buren County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. CHRISTOPHER MICHAEL SIMPSON PA

Physician Assistant