JACOB RUSSELL BRYDE DNP, AGPCNP-BC
NPI 1821836024
Nurse Practitioner - Gerontology in East Lansing, MI

Q: What is Jacob Bryde's NPI number?

The NPI number for Jacob Bryde is 1821836024. It was assigned to this individual provider in the NPPES registry on July 20, 2024.

Q: What is Jacob Bryde's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Bryde was last updated on October 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.

Active since July 20, 2024PECOS EnrolledAccepts Medicare Assignment

804 SERVICE RD STE A110, EAST LANSING, MI 48824(517) 353-2822(517) 355-2824 Get Directions Write a Review

NPPES record last updated: October 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jacob Russell Bryde Dnp, Agpcnp-bc NPPES

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

JACOB RUSSELL BRYDE DNP, AGPCNP-BC (NPI 1821836024) is an individual gerontology provider in East Lansing, Michigan, licensed in Michigan (4704335991) and active in the NPI registry since July 2024. He is enrolled in Medicare PECOS, is affiliated with Henry Ford Health Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1821836024

Entity TypeIndividualMale

Primary Taxonomy363LG0600X

Provider Legal NameJACOB RUSSELL BRYDECredential: DNP, AGPCNP-BC

Location Address804 SERVICE RD STE A110East Lansing, MI 48824-7015

Mailing Address804 Service Rd Ste A202East Lansing, MI 48824-7015 · (517) 355-2822 · Fax (517) 355-2824

Phone(517) 353-2822

Fax(517) 355-2824

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateJuly 20, 2024

Last NPPES UpdateOctober 15, 2024

NPPES CertifiedOctober 15, 2024

✔ NPI 1821836024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in MI · 4704335991

804 SERVICE RD STE A110, East Lansing, MI 48824

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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, McLaren Health Plan Community 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 Russell Bryde Dnp, Agpcnp-bc 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 ID4587197082

PECOS Enrollment IDI20241022005107

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 3

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

Henry Ford Health Hospital

Acute Care Hospitals · Detroit, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230053

Location2799 W Grand BlvdDetroit, MI 48202 · Wayne County

Emergency services Birthing friendly

Mclaren Greater Lansing

Acute Care Hospitals · Lansing, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230167

Location2900 Collins RdLansing, MI 48910 · Ingham County

Emergency services Birthing friendly

Edward W Sparrow Hospital

Acute Care Hospitals · Lansing, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230230

Location1215 E Michigan AvenueLansing, MI 48912 · Ingham County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48824 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.

Other Providers at the Same Location NPPES 8

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

JULIE G THOMAS-BECKETT NP

Nurse Practitioner