1. Home
  2. Directory
  3. Michigan
  4. Roseville
  5. Family Medicine
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

STEPHANIE ICABONE MD
NPI 1740965300
Family Medicine in Roseville, MI

Active since June 20, 2023PECOS Enrolled
30695 LITTLE MACK AVE STE 200, ROSEVILLE, MI 48066(586) 294-9600 Get Directions Write a Review

NPPES record last updated: October 1, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 1, 2026, Jun 20, 2023 (2 updates tracked since 2023).

About Stephanie Icabone Md NPPES

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

STEPHANIE ICABONE MD (NPI 1740965300) is an individual family medicine provider in Roseville, Michigan, licensed in Michigan (4301517563) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Grosse Pointe, and is a graduate of Oakland Univ, William Beaumont School Of Medicine (2023).

NPPES Registry Identity

NPI1740965300
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSTEPHANIE ICABONECredential: MD
Location Address30695 LITTLE MACK AVE STE 200Roseville, MI 48066-1781
Mailing Address26901 Beaumont Blvd Ste 3dSouthfield, MI 48033-3849
Phone(586) 294-9600
Sole ProprietorYes
Medical School CMSOakland Univ, William Beaumont School Of MedicineGraduated 2023
Enumeration DateJune 20, 2023
Last NPPES UpdateOctober 1, 20262 updates tracked since enumeration
NPPES CertifiedOctober 1, 2026
✔ NPI 1740965300 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 · 4301517563
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.
30695 LITTLE MACK AVE STE 200, Roseville, MI 48066
Open in Google Maps ↗

Secondary Practice Location 1

Location 1468 Cadieux RdGrosse Pointe, MI 48230-1507 · Phone (586) 498-4422

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stephanie Icabone Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365801354
PECOS Enrollment IDI20260814003503
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.

Medicare Billing Reassignment

Medicare enrollment records show Stephanie Icabone reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Oakwood Ambulatory LLC
22 mi
Internal Medicine
18101 OAKWOOD BLVD
Dearborn, MI 48124
  • Reassigned Medicare billing, Michigan enrollment
  • 453 clinicians in this Medicare group
NPI 1003829441 (313) 593-7000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48066 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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 7

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

DR. ANTHONY DELISE III MD
Family Medicine
30695 LITTLE MACK AVE STE 200
ROSEVILLE, MI 48066
Macomb County (586) 294-9600
REMANA HASNATH M.D.
Family Medicine
30695 LITTLE MACK AVE STE 200
ROSEVILLE, MI 48066
Macomb County (586) 294-9600
DR. KATHLEEN WENDEL DUCHAK MD
Family Medicine
30695 LITTLE MACK AVE STE 200
ROSEVILLE, MI 48066
Macomb County (586) 294-9600
KATHLEEN M ROLLINGER D.O.
Family Medicine
30695 LITTLE MACK AVE STE 200
ROSEVILLE, MI 48066
Macomb County (586) 294-9600
DR. JOHN ANTHONY VOLLMER M.D.
Family Medicine
30695 LITTLE MACK AVE STE 200
ROSEVILLE, MI 48066
Macomb County (586) 294-9600
ANDREISE LAURIAN NAZZARIA ROSA DE SOUZA
Family Medicine
30695 LITTLE MACK AVE STE 200
ROSEVILLE, MI 48066
Macomb County (586) 294-9600
BRIANA HARKIEWICZ MSN FNP-BC
Nurse Practitioner (Family)
30695 LITTLE MACK AVE STE 200
ROSEVILLE, MI 48066
Macomb County (586) 294-9600

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 Stephanie Icabone's NPI number?

The NPI number for Stephanie Icabone is 1740965300. It was assigned to this individual provider in the NPPES registry on June 20, 2023.

Where is Stephanie Icabone located?

Stephanie Icabone practices at 30695 Little Mack Ave Ste 200, Roseville, MI 48066. The listed phone number is (586) 294-9600.

What is Stephanie Icabone's specialty?

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

Is Stephanie Icabone enrolled in Medicare?

Yes. Stephanie Icabone is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Stephanie Icabone's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stephanie Icabone reassigns Medicare benefits to Oakwood Ambulatory LLC (Dearborn, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stephanie Icabone's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Stephanie Icabone accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company and UnitedHealthcare list Stephanie Icabone 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.

When was this NPI record last updated?

The NPPES record for Stephanie Icabone was last updated on October 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days 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.