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JACOB ICEBERG DO
NPI 1043836612
Family Medicine in Grand Rapids, MI

Active since June 19, 2020PECOS EnrolledAccepts Medicare Assignment
280 60TH ST SE # 200, GRAND RAPIDS, MI 49548(616) 483-0750 Get Directions Write a Review

NPPES record last updated: July 18, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 18, 2023, Dec 5, 2022, Jun 19, 2020 (3 updates tracked since 2020).

About Jacob Iceberg Do NPPES

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

JACOB ICEBERG DO (NPI 1043836612) is an individual family medicine provider in Grand Rapids, Michigan, licensed in Michigan (5101026922) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Des Moines University Of Osteopathic Medicine And Health Sciences (2020).

NPPES Registry Identity

NPI1043836612
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJACOB ICEBERGCredential: DO
Location Address280 60TH ST SE # 200Grand Rapids, MI 49548-8504
Mailing Address280 60th St Se # 200Grand Rapids, MI 49548-8504 · (616) 483-0750
Phone(616) 483-0750
Sole ProprietorNo
Medical School CMSDes Moines University Of Osteopathic Medicine And Health SciencesGraduated 2020
Enumeration DateJune 19, 2020
Last NPPES UpdateJuly 18, 20233 updates tracked since enumeration
NPPES CertifiedJuly 18, 2023
✔ NPI 1043836612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 5101026922
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
280 60TH ST SE # 200, Grand Rapids, MI 49548
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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 Iceberg Do 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 ID2163845058
PECOS Enrollment IDI20231121000624
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.

Hospital Affiliations CMS Care Compare

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

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230038
Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49548 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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 Jacob Iceberg's NPI number?

The NPI number for Jacob Iceberg is 1043836612. It was assigned to this individual provider in the NPPES registry on June 19, 2020.

Where is Jacob Iceberg located?

Jacob Iceberg practices at 280 60th St SE # 200, Grand Rapids, MI 49548. The listed phone number is (616) 483-0750.

What is Jacob Iceberg's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jacob Iceberg enrolled in Medicare?

Yes. Jacob Iceberg 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.

What insurance does Jacob Iceberg accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Jacob Iceberg 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.

Is Jacob Iceberg affiliated with any hospitals?

According to CMS data, Jacob Iceberg is affiliated with Spectrum Health.

When was this NPI record last updated?

The NPPES record for Jacob Iceberg was last updated on July 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.