Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1689761439 Individual Practitioner Male Practitioner

Dr. John J Iacobucci , MD

Surgery - Plastic and Reconstructive Surgery • Grand Rapids, MI

Professional Overview & Biography Verified Profile Summary

Dr. John Iacobucci, MD is a registered healthcare professional specializing in Surgery - Plastic and Reconstructive Surgery in Grand Rapids, MI. Practice services are available at 221 MICHIGAN ST NE STE 300 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

221 Michigan St Ne Ste 300

Grand Rapids, MI 495032537

Telephone 6163911909
Fax 6163918612

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Plastic and Reconstructive Surgery in Grand Rapids, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 26.8 Yrs
State Avg: 22.0 Yrs
Regional Practice Density
10 Specialists

Practicing in Grand Rapids, MI (65 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-06-10
Surgery - Plastic and Reconstructive Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0122X

State License MI 4301047493

A surgeon who specializes in plastic and reconstructive surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
3397368 (MI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

15 Associated Practitioners
NPI 1033558598

Doctor of Medicine (M.D.)

NPI 1114012978

Doctor of Medicine (M.D.)

NPI 1205521069

Doctor of Medicine (M.D.), Master of Science

Dr. Spencer Sims , MD

Orthopaedic Surgery

NPI 1205577244

Doctor of Medicine (M.D.)

NPI 1215562392

Doctor of Medicine (M.D.)

Cheryl Valachovics , NP

Nurse Practitioner

NPI 1306856117

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location June 10, 2020

Registered at 221 MICHIGAN ST NE STE 300, GRAND RAPIDS, MI 495032537 (Tel: 6163911909)

📍
Updated Business Mailing Address June 10, 2020

Registered at 100 MICHIGAN ST NE # MC-845, GRAND RAPIDS, MI 495032560 (Tel: 6163911909)

NPI Profile Active October 23, 2017

NPI status registered as active in NPPES database

📍
Updated Business Mailing Address October 23, 2017

Registered at 550 CASCADE WEST PARKWAY SE SUITE 200, GRAND RAPIDS, MI 49546 (Tel: 6169740100)

📍
Updated Practice Location October 23, 2017

Registered at 80 68TH STREET SE, GRAND RAPIDS, MI 49548 (Tel: 6169740100)

👤
Provider Name / Credentials Updated October 23, 2017

Recorded as JOHN IACOBUCCI, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 23, 2017

Surgery (License #4301047493 in MI)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 80 68TH STREET SE, GRAND RAPIDS, MI 49548 (Tel: 6169740100)

📍
Updated Business Mailing Address July 08, 2007

Registered at 4210 OAK FOREST CT L8, GRAND RAPIDS, MI 49546 (Tel: 6169740100)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN IACOBUCCI, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Surgery (License #4301047493 in MI)

🟢
Initial NPI Registration & Enumeration October 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1689761439
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 05, 2006
Last Update: June 10, 2020
Sole Proprietor: No

Mailing Address

100 Michigan St Ne # Mc-845

Grand Rapids, MI 495032560

Phone: 6163911909

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.