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JACK DANIEL DEGROOT PA-C
NPI 1982950960
Physician Assistant in Grand Rapids, MI

Active since July 27, 2012PECOS Enrolled
1545 68TH ST SE STE 100, GRAND RAPIDS, MI 49508(616) 267-7881 Get Directions Write a Review

NPPES record last updated: February 14, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 14, 2022, Mar 2, 2021, Jun 5, 2017 (3 updates tracked since 2017).

About Jack Daniel Degroot Pa-c NPPES

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

JACK DANIEL DEGROOT PA-C (NPI 1982950960) is an individual physician assistant in Grand Rapids, Michigan, licensed in Michigan (5601006401) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1982950960
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJACK DANIEL DEGROOTCredential: PA-C
Location Address1545 68TH ST SE STE 100Grand Rapids, MI 49508-7896
Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560
Phone(616) 267-7881
Sole ProprietorNo
Enumeration DateJuly 27, 2012
Last NPPES UpdateFebruary 14, 20223 updates tracked since enumeration
NPPES CertifiedFebruary 14, 2022
✔ NPI 1982950960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601006401
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1545 68TH ST SE STE 100, Grand Rapids, MI 49508
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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 (PECOS)

Jack Daniel Degroot Pa-c 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 49508 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
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
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 5

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

BETH ELLEN SHEPHERD LMSW
Social Worker (Clinical)
1545 68TH ST SE STE 100
GRAND RAPIDS, MI 49508
Kent County (616) 267-7881
STASON SCHAFER VANDEGRIFT MD
Pediatrics
1545 68TH ST SE STE 100
GRAND RAPIDS, MI 49508
Kent County (616) 267-7881
BRITTNEY ANNE REYNOLDS LMSW
Social Worker (Clinical)
1545 68TH ST SE STE 100
GRAND RAPIDS, MI 49508
Kent County (616) 267-7881
EMILY RACHEL JONES
Social Worker (Clinical)
1545 68TH ST SE STE 100
GRAND RAPIDS, MI 49508
Kent County (616) 267-7881
LISA ANN WATKINS CPNP
Nurse Practitioner (Pediatrics)
1545 68TH ST SE STE 100
GRAND RAPIDS, MI 49508
Kent County (616) 267-7881

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 Jack Degroot's NPI number?

The NPI number for Jack Degroot is 1982950960. It was assigned to this individual provider in the NPPES registry on July 27, 2012.

Where is Jack Degroot located?

Jack Degroot practices at 1545 68th St SE Ste 100, Grand Rapids, MI 49508. The listed phone number is (616) 267-7881.

What is Jack Degroot's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jack Degroot enrolled in Medicare?

Yes. Jack Degroot is registered in the Medicare PECOS enrollment system.

What insurance does Jack Degroot accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Jack Degroot 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 Jack Degroot was last updated on February 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.