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MALLORY JACOBER
NPI 1871200964
Nurse Practitioner - Pediatrics in Troy, MI

Active since October 31, 2022PECOS Enrolled
44201 DEQUINDRE RD STE EC, TROY, MI 48085(248) 259-3088 Get Directions Write a Review

NPPES record last updated: February 3, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Feb 3, 2023, Jan 24, 2023, Oct 31, 2022 (3 updates tracked since 2022).

About Mallory Jacober NPPES

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

MALLORY JACOBER (NPI 1871200964) is an individual pediatrics provider in Troy, Michigan, licensed in Michigan (4704319264) and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1871200964
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameMALLORY JACOBER
Location Address44201 DEQUINDRE RD STE ECTroy, MI 48085-1117
Mailing Address44201 Dequindre Rd Ste EcTroy, MI 48085-1117 · (248) 964-5111
Phone(248) 259-3088
Sole ProprietorNo
Enumeration DateOctober 31, 2022
Last NPPES UpdateFebruary 3, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2023
✔ NPI 1871200964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in MI · 4704319264
Also ListedNurse PractitionerTaxonomy 363L00000X · License 4704319264 (MI)
44201 DEQUINDRE RD STE EC, Troy, MI 48085
Open in Google Maps ↗

Secondary Practice Locations 2

Location 12440 Shawood StNovi, MI 48377-1970 · Phone (248) 535-2454
Location 244199 Dequindre Rd Ste 502Troy, MI 48085-1128 · Phone (248) 964-5880

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 (PECOS)

Mallory Jacober 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48085 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 20

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

COURTNEY ANNE CROWLEY CPNP-PC
Nurse Practitioner (Pediatrics)
44201 DEQUINDRE RD STE EC
TROY, MI 48085
Oakland County (248) 964-5111
MRS. DANIELLE E BRANIECKI PA-C
Physician Assistant
44201 DEQUINDRE RD STE EC
TROY, MI 48085
Oakland County (248) 964-5111
JENNIFER RITA WALSTER
Physician Assistant
44201 DEQUINDRE RD STE EC
TROY, MI 48085
Oakland County (248) 964-5111
BRITTANY SHAMOUN
Nurse Practitioner
44201 DEQUINDRE RD STE EC
TROY, MI 48085
Oakland County (248) 964-5111
MATTHEW CHRISTENSEN
Emergency Medicine
44201 DEQUINDRE RD STE EC
TROY, MI 48085
Oakland County (248) 964-5111
KIMBERLY KAY BENKNER PNP
Nurse Practitioner (Pediatrics)
44201 DEQUINDRE RD STE EC
TROY, MI 48085
Oakland County (248) 259-3088
SARA K. KLICK PA
Physician Assistant
44201 DEQUINDRE RD STE EC
TROY, MI 48085
Oakland County (248) 964-5111
JASON R HILL PA-C
Physician Assistant
44201 DEQUINDRE RD STE EC
TROY, MI 48085
Oakland County (248) 964-5000

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 Mallory Jacober's NPI number?

The NPI number for Mallory Jacober is 1871200964. It was assigned to this individual provider in the NPPES registry on October 31, 2022.

Where is Mallory Jacober located?

Mallory Jacober practices at 44201 Dequindre Rd Ste Ec, Troy, MI 48085. The listed phone number is (248) 259-3088.

What is Mallory Jacober's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Mallory Jacober enrolled in Medicare?

Yes. Mallory Jacober is registered in the Medicare PECOS enrollment system.

What insurance does Mallory Jacober accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Priority Health list Mallory Jacober 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 Mallory Jacober was last updated on February 3, 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.