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MR. JOHN J IACOBUCCI M.D.
NPI 1689761439
Surgery - Plastic and Reconstructive Surgery in Grand Rapids, MI

Active since October 05, 2006PECOS Enrolled
221 MICHIGAN ST NE STE 300, GRAND RAPIDS, MI 49503(616) 391-1909(616) 391-8612 Get Directions Write a Review

NPPES record last updated: June 10, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 10, 2020, Oct 23, 2017 (2 updates tracked since 2017).

About Mr. John J Iacobucci M.d. NPPES

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

MR. JOHN J IACOBUCCI M.D. (NPI 1689761439) is an individual plastic and reconstructive surgery provider in Grand Rapids, Michigan, licensed in Michigan (4301047493) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689761439
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameMR. JOHN J IACOBUCCICredential: M.D.
Location Address221 MICHIGAN ST NE STE 300Grand Rapids, MI 49503-2537
Mailing Address100 Michigan St Ne # Mc-845Grand Rapids, MI 49503-2560 · (616) 391-1909 · Fax (616) 391-8612
Phone(616) 391-1909
Fax(616) 391-8612
Sole ProprietorNo
Enumeration DateOctober 5, 2006
Last NPPES UpdateJune 10, 20202 updates tracked since enumeration
NPPES CertifiedJune 10, 2020
✔ NPI 1689761439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in MI · 4301047493
Definition
A surgeon who specializes in plastic and reconstructive surgery.
221 MICHIGAN ST NE STE 300, Grand Rapids, MI 49503
Open in Google Maps ↗

Other Identifiers 1

Medicaid3397368MI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. John J Iacobucci M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

BRYAN D ANDERSON PAC
Physician Assistant (Surgical)
221 MICHIGAN ST NE STE 300
GRAND RAPIDS, MI 49503
Kent County (616) 459-7258
DAVID RANNEY
Thoracic Surgery (Cardiothoracic Vascular Surgery)
221 MICHIGAN ST NE STE 300
GRAND RAPIDS, MI 49503
Kent County (616) 459-7258
DR. NEAL MATTHEW FOLEY D.O.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
221 MICHIGAN ST NE STE 300
GRAND RAPIDS, MI 49503
Kent County (512) 789-5674
DAVID DREW PA-C
Physician Assistant (Surgical)
221 MICHIGAN ST NE STE 300
GRAND RAPIDS, MI 49503
Kent County (616) 459-7258
ELIZABETH VICTORIA BALAJ PA-C
Physician Assistant
221 MICHIGAN ST NE STE 300
GRAND RAPIDS, MI 49503
Kent County (616) 459-7258
EDWARD T MURPHY MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
221 MICHIGAN ST NE STE 300
GRAND RAPIDS, MI 49503
Kent County (616) 459-7258
JENNIFER KEEGSTRA
Nurse Practitioner
221 MICHIGAN ST NE STE 300
GRAND RAPIDS, MI 49503
Kent County (616) 459-7258
MARZIA LEACCHE M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
221 MICHIGAN ST NE STE 300
GRAND RAPIDS, MI 49503
Kent County (616) 459-7258

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 John Iacobucci's NPI number?

The NPI number for John Iacobucci is 1689761439. It was assigned to this individual provider in the NPPES registry on October 5, 2006.

Where is John Iacobucci located?

John Iacobucci practices at 221 Michigan St NE Ste 300, Grand Rapids, MI 49503. The listed phone number is (616) 391-1909.

What is John Iacobucci's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is John Iacobucci enrolled in Medicare?

Yes. John Iacobucci is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for John Iacobucci was last updated on June 10, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.